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Making Child Care Better: State Initiatives--October 1999
Executive Summary

Written by:
Scott Groginsky
Susan Robison
Shelley Smith

With increasing evidence that good early childhood programs lead to school success, reduced delinquency and crime, and better job opportunities and productivity, state legislators are making policies to improve these important services. Enacted laws have expanded child care training, advanced quality preschool programs, and linked early childhood services to comprehensive health and social services. Legislative interest in this issue has been furthered in part by increased child care demand from new welfare laws and by research that brain development is significantly affected by experiences in the first three years of life.

Approximately 13 million American children are in out-of-home child care programs, and a child's early child care and education experiences have a dramatic effect on his or her short- and long-term development. Yet, numerous studies have found that child care services generally are mediocre to poor for a range of settings. State legislators and other policymakers have addressed this concern by focusing on improving child care quality in a variety of ways. A base measurement of quality levels is state regulation, which includes licensing standards for child-to-staff ratios, professional qualifications and physical space, among others. These standards represent a minimum level of health and safety for a child. In recent years, state decision makers have gone beyond regulations to make child care experiences better for young children. Four key ways that legislatures are moving in this direction include:

Child care includes programs that are provided in a variety of settings. These include:

Many studies have associated good quality child care programs with positive outcomes for children, including better language, cognitive and social skills, fewer behavioral problems and stronger mother-child relationships. Long-term research studies on preschool and early intervention have found that children in good programs have better job achievement and academic success, as well as fewer arrests. These studies also have found that such comprehensive early childhood services result in government savings through increased taxes, decreased welfare spending, less social services, and lower criminal justice costs.

States are drawing on a variety of sources to pay for better quality child care programs because these programs typically cost more. Federal sources include the Child Care and Development Block Grant (CCDBG), the Temporary Assistance for Needy Families (TANF) Block Grant, and the Social Services Block Grant (SSBG). States also are investing in good quality initiatives with state funds and are working to involve employers in financing strategies.

State policymakers can bolster child care quality by expanding training and education opportunities for child care teachers and providers, which research has identified as critical to improving child outcomes in many areas. Training and education for providers that focus on child development issues have been shown to be particularly effective in supporting more learning environments and better teacher-child interactions. During the past several years, many legislatures have used state and federal funds to support training and education for child care providers. They also have drawn on other innovative sources, such as loan funds, a tax checkoff, special license plates, child care license fees, and business money. States also target training and education services for professionals who specialize in certain areas, such as caring for infants and toddlers or children with special needs, and for different positions, such as directors or administrators.

State lawmakers also are concerned about recruiting and retaining providers, including education incentives and linkages between training and wages. Among legislative strategies have been to forgive student loans or to appropriate funds for scholarships for someone who chooses to earn educational credit in child development. Although a variety of studies has identified wages as a key element of a good quality child care program, low pay and a general lack of benefits for providers and teachers have contributed to a high turnover rate in the field. To address this problem, some state policies have concentrated on rewarding higher salaries to those early childhood professionals who complete more training or education. Several states have similarly focused on improving health benefits for these early childhood workers.

 Improving provider compensation is one aspect of a coordinated early childhood career development system. An effective system also includes career ladders and paths, more accessible college admission policies, mentoring and apprenticeships, and knowledge about and competency in core issues. Recognizing the connection between a more educated and professional work force and good child outcomes, policymakers in almost all states have begun active training and career development initiatives. Most states work closely with resource and referral services to advance these initiatives.

In addition to promoting a more educated staff and a better career system, state policymakers can improve early childhood quality by establishing voluntary standards that exceed state licensing regulations. These voluntary standards range from national accreditation standards to state-set standards and performance standards for prekindergarten programs. Accreditation factors generally include professional qualifications and development, health and safety standards, administration, curriculum, staff-child interactions, staff-parent interactions, environment and evaluation. Several different organizations accredit part- and full-day early childhood programs. Numerous studies have correlated accreditation with better quality, particularly in regard to lower child-to-staff ratios and teacher sensitivity, and especially when accredited programs have better paid teachers.

During the past several years, state legislatures have developed policies that provide for accreditation mostly through funding and other incentives. Specifically, states have authorized higher payment levels for accredited care, provided grants that support technical assistance to help workers become accredited, and officially recognized programs that have achieved accreditation. Varying somewhat from national accreditation, some states have established their own set of voluntary child care and prekindergarten standards that promote good quality services. Through official recognition of this special status, these state standards can serve as an incentive for child care programs to voluntarily pursue better quality care. About a third of the states require their preschool programs to include specific high-quality, state-set standards, such as lower child-to-staff ratios, staff qualifications, curriculum and practice, and parental involvement.

To encourage child care centers and homes to establish good quality standards, legislatures have enacted laws that create higher reimbursement rates for such programs that serve children who receive subsidies. A growing number of lawmakers have authorized higher payments for providers who meet national accreditation standards, stricter licensing standards or other quality of care standards. For these differential reimbursement rates to have a meaningful effect, it is critical that rates come close to representing the actual costs of care. Increasingly, state policymakers are recognizing that child care providers may be inadequately reimbursed in general, which can affect the supply and quality of care provided to children from low-income families. In 1998, more than half the states increased reimbursement rates for some or all providers of state-subsidized care. In addition, some states have required that market surveys that determine rates be updated annually or every other year.

Some states have established tiered reimbursement systems with two or more levels of quality categories. In some cases, reimbursement categories are based on differently rated licenses, depending on certain quality indicators such as teacher education, training or experience, parent interactions and planning. Other states pay child care providers a higher reimbursement rate if their center or home is accredited by a national accrediting organization. Some states combine accreditation and licensing standards to determine differential rate payments. University researchers have embarked on a study to measure the effects of variable reimbursement systems as well as ranking systems that are not tied to remuneration. To test this promising approach in their own states, policymakers may want to consider closely tracking the outcomes of tiered reimbursement systems.

State policymakers are increasingly looking at ways to improve child care and early education programs by including health and other social services that can help families address multiple needs and concerns. Such comprehensive services can improve overall early childhood experiences by addressing the range of important issues that affect young children, such as lack of adequate nutrition and health care, family conflict, divorce, child abuse and neglect, teen pregnancy, domestic violence, and community violence and crime. Key to the success of early intervention is a breadth and quality of services and programs that combine good child care with services for parents.

Increasingly, legislatures are restructuring the multitude of categorical programs and funding streams that often result in independent, uncoordinated efforts. Lawmakers are considering more effective use of public resources by establishing early childhood partnerships with parents, businesses and community groups. One such approach is to coordinate child care with prekindergarten programs and Head Start. Head Start and other state prekindergarten programs that have demonstrated good long-term outcomes for children and families usually include comprehensive services such as health care, parental involvement and access to other key social services such as parent education, counseling and job linkages. In addition, state policymakers are building on the integral role that schools have in fomenting coordinated, comprehensive approaches to child care and early education, including services for infants and toddlers.

Some states are improving the quality of child care programs by including or coordinating them with family support services. This approach has grown from the concerns, interests and needs of families. Typically, they offer some combination of parent education classes, support groups, job training, literacy tutoring, various health screenings, information and referrals, family activities, advocacy, crisis intervention, family counseling and child care. Home visitors, school-based centers, or other professionals in neighborhood facilities may provide services. Research has shown that family support initiatives provide many benefits, and state legislatures have included child care and early education programs in the family support context. A primary example of this is coordinating health services in child care settings, including health insurance, mental health services, nutrition services, and education about preventative health care.

Another legislative trend is forging new state-local partnerships that share early childhood decision making with communities, providing them with greater flexibility in program design and funding. Several states have demonstrated great success with this devolved policy. Legislators and other policymakers in some states are closely examining specific children and family outcomes when developing early childhood policies, serving as a framework for planning, implementing and tracking services.

This publication highlights critical ways that state legislatures can improve child care and early education services above and beyond regulatory requirements. The last several years have seen innovative advancements in several key areas. These include greater professional opportunities for providers, a focus on voluntary accreditation and other program standards that promote good quality services, fiscal incentives in the form of variable reimbursement rates to high-quality programs, and establishment of early childhood initiatives that are enriched with comprehensive health and social services. State legislative initiatives that promote good quality child care and early education have a significant effect on future generations, with implications for education, criminal justice and the economy.

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