This report summarizes activities U.S. Government (USG) agencies are undertaking together to improve programming for highly vulnerable children and the steps they have taken and plan to take to implement Public Law 109-95. It covers the period of July 2007 through July 2008. This report contains many examples of how USG agencies have worked together, as well as with international donors, nongovernmental organizations, and host countries, to learn from each others' experiences and to improve programming. Select reporting period highlights include examples drawn from each of the major areas of vulnerability for children. These examples affirm that USG departments and agencies are focusing attention on child protection, along with humanitarian services, in addition to delivery of key services, and that programs aimed at highly vulnerable children increasingly provide more than one service. Additionally, the past year has seen improvements in information exchange among USG agencies. Successful innovations are being expanded in order to improve programming and services. Departments and agencies have acknowledged the key challenges they face in collaborating together.