Prior to ABCD II, Iowa's early childhood efforts focused on day care, early education, and public health services. Since ABCD II, there has been a growing appreciation of the role the private primary health care provider plays in the system. Private health care providers are now invited and engaged in planning and policy efforts at both the state and community levels.

Iowa established three levels of services, focusing on preventive services, including screening, assessment, family risk factors, counseling, and care coordination for all Medicaid eligible children; developmental services, such as problem-based counseling and coordination of care for all Medicaid eligible children identified at risk for developmental or emotional problems; and intensive developmental or mental health services for those children identified in need of therapy.