Encouraging Better Child Care

Encouraging Better Child Care

Statestats

State Legislatures Magazine - December 1999

Map: States with tiered reimbursement rates

Ninteen states have "tiered" reimbursement systems that pay centers and homes caring for low-income children on state support more when they upgrade their programs.

As states pick up the tab for an increasing number of low-income children enrolled in child care, they are using this support to try to improve the quality of that care. Some 13 million American children are in child care programs. What happens there has a dramatic effect on their later success in school, the likelihood of involvement in delinquency and crime, and the job opportunities open to them in adulthood. Yet numerous studies have found that child care services in our country are generally mediocre to poor.

Nineteen states have introduced "tiered" reimbursement systems that pay centers and homes caring for low-income children on state support more when they upgrade their programs. The tiered reimbursement rates are based on such things as national accreditation standards, stricter licensing requirements or other quality standards like lower child-to-staff ratios, teacher training, curriculum and parent involvement. Since most child care centers operate on minimal budgets, increased reimbursement gives them the money to invest in improving their services.

In some cases, reimbursement categories are linked to differently rated licenses, based on certain qualifications such as teacher education, training and experience; parent interactions; and planning. Other states pay higher rates to centers or homes accredited by a national organization. Some states combine accreditation and licensing standards to determine the different rates.

Although the rating systems vary from state to state, they offer, for the first time, a set of criteria that government contractors and parents can use to make choices. The number of payment tiers in these reimbursement systems ranges from two to six, but most states offer two. New Mexico, North Carolina, Oklahoma and South Carolina have more than two levels. Researchers at Georgetown University's Public Policy Institute have found that some state differential reimbursement rates have had some impact on increasing accreditation. Preliminary results are expected soon.

For more information on quality child care and reimbursement rates see NCSL's new book, Making Child Care Better: State Initiatives.