Across America, in living rooms and classrooms, in houses of worship and community centers, on street corners and in parks, families are doing their best to care for their children. Sometimes, parents and caregivers need extra support along the way, especially when they are living in adverse conditions marked by poverty, homelessness, violence and substance misuse. At the 2017 Winter Meeting of the National Governors Association (NGA), attendees were inspired by a plenary session that highlighted the importance of the early years of childhood development. In response to governors' interest in early learning, NGA focused on the role that governors can play in supporting children from birth to age 3 and their families. Following the winter meeting, staff from several governors' offices reached out to NGA for additional information. The NGA Center for Best Practices' (NGA Center) education, health and human services divisions collaborated to support the governors' requests. NGA Center convened an expert roundtable conversation in June 2018 to review the latest research and learn about current state efforts in this space. This report includes the vision statement that emerged from the roundtable, and the essential elements for integrated prenatal to age 3 policies were defined.