States Increasing Supports for Early Childhood Programs

February 02, 2023 | Shannon Vance

Parent and child walk hand-in-hand up school. ASTHO Health Policy Update banner, lower leftEarly childhood programs—such as childcare centers, Head Start, and preschool—help prevent or identify early health problems that impact learning later in life. They also decrease dependence on social welfare, reduce crime-related costs and incarceration rates later in life and set a child up for academic success. Studies show that every dollar invested in quality early childhood programs yields up to $16 in returns (i.e., better health, education, and social outcomes). Studies also show that participating in quality early childcare can help children avoid special education, grade repetition, and early parenthood. Additionally, studies have shown that the economic benefits of affordable childcare can extend across generations.

Despite these widespread benefits, about half of the U.S. population lives in places where there is either no licensed childcare provider or where children greatly outnumber available spots. Additionally, childcare accounts for roughly one third or more of household income. For those who can both access and afford care, only about 10% of providers are considered high quality.

The COVID-19 pandemic diminished quality childcare opportunities, with many not reopening after disease prevention measures were lifted. The pandemic also further exacerbated existing disparities, such as a lack of childcare options for families who work non-traditional hours and those who rely on public funds, many of whom are Black or Latino.

Increasing Access to Early Childcare Services

Looking to the future, states are improving access to care, providing subsidies for tuition costs, and expanding hours of licensed facilities. Increasing access to early childcare services means ensuring affordability, transportation to and from care is reasonable, as well as meeting the parents’ and the child’s needs.

  • In 2022, Hawaii enacted HB 1600, which restored $7 million to the Preschool Open Doors subsidy, providing subsidies to low- and moderate-income families to help pay preschool tuition fees.
  • Utah’s HB 15 addresses several childcare issues, most notably increasing the number of children an in-home childcare provider may care for at one time to six in a state where affordable child care is in short supply.
  • Illinois passed HB 1571 in 2022, creating the Off-Hours Child Care Program, which awards grants to licensed childcare facilities to help caregivers who work non-traditional hours.
  • In 2022, Maryland enacted a package of bills dedicating resources for childcare stabilization (HB 89), capacity expansion, and improvement of facilities through no-interest revolving loans (HB 993). HB 995 requires the Department of Education to establish a process that grants presumptive eligibility for a childcare subsidy, removes the requirement that applicants either receive or pursue child support, and eliminates copayments for parents enrolled in safety net programs such as WIC. HB 1100 appropriates $16 million to the Department of Education to distribute to childcare centers for the awarding of bonuses to their staff.

Ensuring Licensed Care Centers and Workforce

A key component of accessing quality childcare is ensuring that there are ample licensed centers, complete with a robust and properly trained workforce. More than two years after the start of the COVID-19 pandemic, the childcare workforce—primarily made up of women—has yet to return to pre-pandemic levels.

Childcare workers are some of the lowest paid workers in the United States and are less likely to have employer-paid benefits. Centers around the country are serving fewer children than their full capacity due to an inability to hire or retain enough staff. Without widespread change, many are concerned the sector will not recover. In addition to providing additional monetary support to staff salaries, states can also consider assisting with provider training, quality improvement and policies on childcare staff qualifications.

  • Washington State dedicated additional funding to the Fair Start for Kids Act (SB 5237)—originally enacted in 2021—to increase compensation and provide health insurance and professional development opportunities for childcare center staff.
  • Idaho’s HB 764, passed during the 2022 legislative session, extends the Child Care Grant program and provides $100 million to stabilize the state’s childcare industry through monthly grants that assist facilities with staff retention and monthly bills
  • During their 2021 legislative session, Texas enacted HB 2607, which requires publicly funded childcare providers to participate in a previously voluntary quality rating and improvement system (QRIS), Texas Rising Star. Mandatory enrollment in the state’s QRIS will improve the quality of care available by certifying licensed facilities based on a range of criteria including staff qualifications, educator-student interactions, nutrition, and physical space.
  • As part of their 2023 education budget, Alabama is investing an additional $17.8 million in Alabama Quality Stars, which is the state's childcare QRIS. This funding will incentivize childcare centers to improve their facilities. This is part of Alabama’s HB 135, offering broader $35 million investment in childcare and includes specific funding for rural childcare programs.
  • For home-based childcare providers, Indiana passed HB 1222 which addresses previous loopholes in background checks for childcare providers. Previously, the law only required workers who were in direct contract with children (i.e., educators or caregivers) to undergo a criminal background check. HEA 1222 requires criminal background checks for all staff and gives the Family and Social Services Administration the ability to revoke or deny licensing based on a household member’s conviction for certain criminal offences.

Looking forward, states can positively impact childcare and early childhood education in many ways. Cross-sector collaboration with education officials, licensed childcare center staff, families, and legislators are crucial for success. Policies that increase high-quality childcare can prevent adverse childhood experiences, encourage the development of a child’s social and emotional skills and provide access to regular meals. State officials can explore the creation of subsidies and tax credits, increase benefits afforded to full and part time childcare staff (i.e., professional development or broader health insurance coverage), and expand programs focused on infant and early childhood mental health.