HHS Fatherhood Initiative

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Overview: Committed parents are crucial to strong and successful families and to the well-being of children. The U.S. Department of Health and Human Services (HHS) is determined to ensure that its programs and policies recognize the importance of both mothers and fathers and that we support men and women in their roles as parents.

In June 1995, President Clinton challenged all federal agencies to reach out to fathers to support their positive involvement in the lives of their children. In May 1996, federal agencies came together in a conference hosted by Vice President Gore, and sponsored by the Domestic Policy Council, the National Partnership for Reinventing Government, and HHS, to share lessons learned and innovative ideas about involving fathers. In June 1998, Vice President Gore released the report, "Nurturing Fatherhood: Improving Data and Research on Male Fertility, Family Formation and Fatherhood." This report, issued by the Federal Interagency Forum on Child and Family Statistics, is the result of a multi-year effort to identify what we know about fatherhood and what additional government research could be undertaken to increase our understanding of how fathering and family structure affect child and adult well-being.

HHS is promoting responsible fatherhood by improving work opportunities for low-income fathers, increasing child support collections, enhancing parenting skills, supporting access and visitation by non-custodial parents, reducing domestic violence, and involving boys and young men in preventing teenage pregnancy and premature parenting. HHS is also working with private, public, and foundation partners to ensure that both fathers and mothers are fully involved in raising their children, not just the first day, but every day of their children's lives. In March 1999, the department launched a nationwide public service campaign challenging fathers to remain connected to their children even if they do not live with them.


Research shows that children benefit from positive relationships not only with their mothers but also with their fathers:

* Higher levels of father involvement in activities with their children, such as eating meals together, going on outings, and helping with homework, are associated with fewer behavior problems, higher levels of sociability, and a higher level of school performance among children and adolescents;

* Father involvement in children's schooling, such as volunteering at school and attending school meetings, parent-teacher conferences and class events, is associated with higher grades, greater school enjoyment, and lower chances of suspension or expulsion from school; and

* The father-child relationship affects daughters as well as sons. Girls who live with both their mother and father do better academically. In addition, they are less likely to engage in early sexual involvement and in the use of alcohol or drugs.

Keeping fathers connected to their children and increasing fathers' involvement in the lives of their children poses significant challenges for our nation:

* High rates of divorce, non-marital child bearing, and the financial and emotional stresses of raising children with severe special health care needs increase the risk that fathers will be less involved in their children's lives; and

* As more families have two parents working outside the home, fathers need support in the work place to find ways to balance work and family obligations and provide children with the level of child-parent involvement and supervision needed for their healthy growth and development.

While government cannot make good fathers, it can support efforts to help men become the best fathers they can be.


Improving Child Support Collections.
An important part of being a responsible parent is providing financial support. Research also suggests that there is a positive relationship between non-custodial fathers' involvement with their children and their payment of child support. The Clinton Administration, in partnership with states, has made a strong effort to increase child support payments from non-custodial parents - mothers as well as fathers. In FY 1998, the federal-state partnership collected a record $14.4 billion from non-custodial parents, an increase of 7 percent from 1997's $13.4 billion, and an increase of 80 percent since 1992 when $8 billion was collected. In addition, HHS reported the federal government collected over $1.1 billion in delinquent child support from federal income tax refunds for tax year 1997. This amount was 3 percent higher than the previous year and a 70 percent increase since 1992. Collections were made on behalf of nearly 1.3 million families.

HHS' Office of Child Support Enforcement publishes a monthly newsletter, Child Support Report, that often includes news and feature stories about fathers and fatherhood. Current and past issues are available on the Web at /programs/cse (click on "News & Announcements.")

Promoting Employment Opportunities for Low-Income Fathers. Seven states are participating in Parents' Fair Share, a demonstration project that provides employment-related training, parenting education, peer group support, and mediation services to encourage low-income fathers to be more involved with their children and increase their payment of child support. In addition, eight states have received demonstration grants or waivers through the Office of Child Support Enforcement to allow them to test comprehensive approaches to encourage more responsible fathering by non-custodial parents. Each state project is different but they all provide a range of needed services such as job search and training, access and visitation, social services or referral, case management and child support.

HHS is working closely with the Department of Labor to implement the Welfare to Work program, which provides grants to states and communities to move long-term welfare recipients and certain non-custodial parents of children on welfare into lasting, unsubsidized employment. The Administration's Work to Welfare reauthorization would help more low income fathers work, pay child support and play a responsible role in their children's lives. In addition, HHS' Administration for Children and Families (ACF) recently released A Guide to Funding Services for Children and Families Through the Temporary Assistance for Needy Families (TANF) Program, available at /programs/ofa/funds2.htm, which provides examples of ways states could use their TANF funds to support responsible fatherhood efforts and employment of non-custodial parents.

Expanding Partners for Fragile Families. ACF has begun a partnership with the private-sector initiative, Partners for Fragile Families. This initiative is aimed at helping fathers work with the mothers of their children in sharing the legal, financial, and emotional responsibilities of parenthood. Activities funded by ACF include Fatherhood Development Workshops on effective practices for working with young unemployed and underemployed fathers; the development of a manual for workers to use in helping low-income fathers learn to interact more effectively with the child support enforcement system; and a peer learning college for child support enforcement experts to identify systemic barriers these young fathers face in becoming responsible fathers. HHS is working with private funders on developing a ten-site Partners for Fragile Families demonstration.


Encouraging Fathers to "Be Their Dad." In March 1999, HHS launched a new, nationwide public service campaign challenging fathers to remain emotionally and financially connected to their children even if they do not live with them. The campaign's tag line is, "They're your kids. Be their dad." and stresses the importance of fathers by showing the consequences for children when fathers do not have a positive role in their children's lives. More than a quarter of American children - nearly 17 million - do not live with their father. Girls without a father in their life are two and a half times as likely to get pregnant and 53 percent more likely to commit suicide. Boys without a father in their life are 63 percent more likely to run away and 37 percent more likely to abuse drugs. Both girls and boys without father involvement are twice as likely to drop out of high school, twice as likely to end up in jail and nearly four times as likely to need help for emotional or behavioral problems.

Improving Paternity Establishment. ACF has instituted voluntary paternity establishment programs in U.S. hospitals to foster father-child bonds right from the start. In FY 1998, nearly 1.5 million paternities were established, an increase of 185 percent or triple the number from the 512,000 in FY 1992. Of these, more than 600,000 were in-hospital paternities voluntarily acknowledged, up from 84,000 in 1994. Voluntary hospital-based paternity establishment services are required to be available in all hospitals and birthing centers. Some states are reporting that they are establishing paternities in the hospital for over 60 percent of non-marital births.

Promoting Parental Access and Visitation. Since FY 1997, HHS has awarded $10 million in block grant funds annually to all 50 states, the District of Columbia, and U.S. territories to promote access and visitation programs to increase non-custodial parents' involvement in their children's lives. Grant size is based on the number of children in a state not living with both parents. In FY 1999 the minimum allotment per state is $100,000. Each state has flexibility in how it designs and operates these programs and can use these funds to provide such services as voluntary or mandatory mediation, counseling, education, development of parenting plans, visitation enforcement (including monitoring, supervision, and neutral drop-off and pick-up), and development of guidelines for visitation and alternative custody arrangements.

Engaging Fathers Early. HHS recognizes that fathers play an important role in their children's early development. The Early Head Start program was specifically designed to ensure maximum involvement of the important men in very young children's lives. A special "Fathers Studies" component has been developed as part of the Early Head Start research and evaluation program to examine the contribution of poor fathers to early childhood development and how program interventions can strengthen father involvement. The Head Start program continues to develop new and innovative ways to increase the parenting skills of both fathers and mothers and to engage them in program activities. Several HHS regional offices have developed partnerships with fraternal organizations to develop programs for encouraging minority fathers in their efforts to be more involved in their children's lives.


Improving Infant Health through Father Involvement. The Healthy Start Program was designed to develop strategies at the community level to reduce infant mortality and low-birth weight babies. Several Healthy Start Demonstration Programs have developed male mentoring and fatherhood initiatives as part of their strategy to improve the health of women, children, and families. These initiatives include using male outreach workers to involve fathers, providing job training and links to substance abuse programs for fathers, furnishing transportation and child care services to increase fathers' participation, and developing rites of passage programs for adolescents boys.

Mobilizing for Fathers and Their Special Needs Children. The Health Resources and Services Administration (HRSA) continues to support fathers who have children with developmental disabilities and chronic illness, and their families, through the National Fathers' Network (NFN). In April 1999, the NFN held a state "Interagency Forum on Fatherhood" in Philadelphia, which brought together male caregivers, public agency and program representatives, family advocacy groups, private organizations, and community-based groups to learn effective strategies in making programs more "father-friendly." The forum also featured the NFN's training video, "Equal Partners, African American Fathers and Systems of Care," which has been distributed to health care providers and programs working with fathers and to the Head Start community. Other activities to support the role of fathers have been funded through HRSA's federal block grants to states. Recent efforts in Washington state, for example, included the State Early Childhood Conference and the annual "Fathers Conference."

Increasing Fathers' Involvement in their Children's Health Care. The Health Care Financing Administration (HCFA) has conducted four focus groups with custodial and non-custodial fathers and mothers to determine barriers to their greater involvement in their children's health care. The focus groups included urban, rural, native Alaskan, and Hispanic-Latino fathers. Information from the focus groups will be used to identify and remove barriers to services. In 1999, HCFA plans to conduct additional focus groups with fathers in Asian American and Pacific Islander communities.

Reducing Family and Community Violence. As part of the Administration's comprehensive strategy to prevent domestic violence, HHS convened a meeting with fatherhood programs to discuss the issues of domestic violence within the context of Temporary Assistance for Needy Families (TANF) requirements to cooperate in the establishment of paternity and child support. State demonstrations have been funded to examine issues of domestic violence and custodial parents' non-cooperation with the child support enforcement requirements. HHS is also coordinating a multi-year cooperative agreement with a consortium of Historically Black Colleges and Universities to develop models to prevent minority male violence. Finally, the Centers for Disease Control and Prevention (CDC) is working to reduce family and community violence, particularly among young boys and adolescent males.

Connecting Fathers to Communities through Public-Private Partnerships. Over the past year, HHS and its regional offices have sponsored a variety of forums to bring together local public and private organizations and individuals to support fathers' involvement in their families and communities. For example, Region V convened a Fatherhood Initiative Forum in Detroit, Mich., and a Title X Family Planning Conference in Chicago, Ill., to discuss strategies for promoting male involvement in teen pregnancy prevention. In addition, regions VIII, IX, and X joined other organizations in supporting a "Strengthening Families through Public/Private Partnerships: Connecting Fathers" Conference in Oakland, Calif. Finally, ACF joined fatherhood and foundation partners in convening a "Listening Session on Tribal Fatherhood Issues" to identify the needs of fathers and families in tribal communities.


Increasing Reproductive Health Outreach to Young Men.
Through HHS regional offices, small grants have been awarded to Title X family planning clinics to develop pilot programs designed to prevent premature fatherhood. These projects employ male high school students as interns to provide them with on-the-job training in clinic operations and allied health occupations and education about male responsibility, family planning and reproductive health.

Promoting Family Planning Services for Men. Twenty community-based organizations specializing in educational and social services for men have been awarded almost $3 million in grants to develop and implement family planning and reproductive health services. A specialized training plan for project staff will be established in FY 1999 to integrate research findings on male reproductive health activities into male-oriented programs.

Information on Prevention Programs for Boys and Young Men. Projects have also been funded to identify abstinence programs for boys and young men and to develop a strategy to provide information to states and local communities on promising abstinence and contraceptive-based programs.


Increasing Knowledge about Fathers.
The Federal Interagency Forum on Child and Family Statistics'report, Nurturing Fatherhood: Improving Data and Research on Male Fertility, Family Formation and Fatherhood, is available on the HHS Fatherhood Initiative Web site at (click on the Forum page). HHS is collaborating with other federal agencies, researchers, and private foundations to implement the recommendations of the Forum's report:

* HHS' National Institute of Child Health and Human Development (NICHD) is supporting the inclusion of questions in the National Longitudinal Survey of Youth (NLSY-97) to further understanding of the process by which young men enter fatherhood and how their experiences condition their journey into adulthood. This survey, sponsored by the Bureau of Labor Statistics, is following a nationally representative sample of young men and women who were aged 12-17 in 1997 and who are now approaching the age at which some will become parents.

* The National Survey of Family Growth, sponsored by CDC's National Center for Health Statistics, will be expanded to ask men directly about their fertility, family formation and fathering experience. Currently only women are interviewed in this survey.

* Interagency collaboration has begun on developing a baseline indicators report on male fertility, family formation, and fathering and a set of standard questions on father-child involvement for use in national household surveys.

* NICHD and the Office of the Assistant Secretary for Planning and Evaluation are helping to fund questions about fathering behavior in the U.S. Department of Education's Early Childhood Longitudinal Survey-Birth Cohort study.

In addition to the above activities, HHS agencies support a number of ongoing research and data collection activities. For example:

* NICHD is supporting a 20-city study to explore the functioning of "fragile families," that is, families formed through non-marital childbearing, and how they affect children's development. The study has made a concerted effort to actively engage fathers, including fathers who live apart from their children on a permanent or intermittent basis.

* NICHD supports several studies involving fathers of children with mental retardation or developmental disabilities. Researchers are trying to answer a variety of questions, ranging from fathers' perceptions of mental retardation, including its causes and treatments, to how fathers can enhance the social development of their disabled children. In addition, researchers are evaluating the effects that living with a developmentally disabled child has on the fathers' psychological well being.

* ACF supports an analysis of longitudinal data from a home-visiting program to understand how home-visitation programs affect fathers' later involvement in the family.

* The National Institute on Alcohol Abuse and Alcoholism (NIAAA) funds numerous studies on the role of family in the development and prevention of alcohol disorders among children and adolescents. For example, NIAAA researchers are examining the association between severity of alcohol dependence and psychopathology in female offspring of alcoholic fathers. An estimated 22 million U.S. adults are children of alcoholics, and previous epidemiologic research has focused on the males among this group. The resulting data will help in the development of preventive measures.

* The National Institute on Drug Abuse supports research on the effects of paternal substance use on children's substance use and on the effectiveness of family-focused drug abuse treatment programs.

Other research and evaluation reports already completed by HHS are available on the above-mentioned web site.


To help our employees balance the demands of the workplace with the needs of the family, HHS launched the Quality of Work Life Initiative in December 1996 and established the Work/Life Center in January 1998. A survey completed by HHS employees on the availability and use of family-friendly work force policies, including flexible work schedules and sites, the Family and Medical Leave Act and other leave programs, and job-sharing, is being used to improve employees' knowledge of, and access to, these Department-wide programs and to make appropriate adjustments where indicated. For example, the Work/Life Center has added father-oriented programs (e.g., "Tools for Dads") to its employee education series. In November 1998, the HHS Union-Management Partnership Council and the Work/Life Center sponsored the first annual Secretary's Conference on Family Friendly Work Practices, entitled "The Challenge of the Flexible Workplace: Meeting Individual and Organizational Needs." The conference included a presentation on fathers and flexible work practices by James Levine, Ed.D. of the Families and Work Institute in New York. Conference participants made specific recommendations for further implementation of family friendly work practices at HHS.

The HHS Fatherhood Initiative Web site is
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