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NPR
Our Fragmented,
Patchwork Care System
In the past 50 years, the experience of the American family has
undergone a sea change. In the mid-twentieth century,
breadwinner-homemaker families were not only more the norm, but held up
as the ideal. Today, there is no one “typical” American family. And in
a majority of families with children under 18, all parents work for pay
outside the home. That means, on any given day, about 12 million
children under the age of five will need a safe place to go and someone
loving to care for them.
On any given day, about 12 million children under the age of five will
need a safe place to go and someone loving to care for them.
A good early care and learning system should support the healthy
development of children, particularly at a time when their brains are
rapidly growing and laying the foundation for all future learning. A
functioning system should sustain the financial stability and health of
families, promote opportunity and equity, support and sustain
businesses, and help the economy thrive. And an effective system should
be built on three pillars: affordable cost, high quality, and easy
availability.
That is not happening in the current fragmented, patchwork system.
The Care Index, a data and methodology collaboration between New
America, Care.com and others, examined cost, quality, and availability
data in all 50 states and the District of Columbia and found that no
single state does well in all three categories. Instead, families,
providers, and policymakers in every state make difficult compromises
that often shape family decisions and can determine the course of
children’s futures.
The Care Index found that the average cost of child care in a center is
nearly one-fifth of U.S. household median income. (U.S. Department of
Education / CC2.0)
The Care Index found that child care is expensive, even though
caregivers make poverty wages; that care can be difficult to find, and
that, though quality is difficult to measure, only a handful of centers
and family homes are nationally accredited for quality. More
specifically, the Care Index found:
The average cost of full-time care in child care centers for all
children ages 0-4 in the United States is $9,589 a year, higher than
the average cost of in-state college tuition ($9,410). To cover the
cost of full time in-center care for one child, a family earning at the
median household income would need to spend one-fifth (18 percent) of
its income. For an individual earning at the minimum wage, full time
in-center care is even less affordable: Child care costs two-thirds (64
percent) of their earnings.
Nationally, the cost of full-time care in child care centers is 85
percent of the monthly U.S. median cost of rent. In four
states—Kentucky, Montana, Oregon, and Wisconsin—the cost of full-time
care is more than the median rent in the state. In 11 states—Idaho,
Illinois, Iowa, Kansas, Massachusetts, Michigan, Minnesota, Ohio, South
Dakota, Vermont, Washington—and the District of Columbia, full-time
care is greater than 90 percent of the typical cost of rent.
The cost of infant care in centers is 12 percent higher than for older
children, and outstrips the cost of in-state tuition and fees in 33
states. Full-time infant care in centers ranges from a low of $6,590 in
Arkansas, about 15 percent of median income, to a high of $16,682 in
Massachusetts, where it costs one quarter of the median income.
The average cost of full-time care using an in-home caregiver, or
nanny, is $28,353 a year. That’s equal to 53 percent of U.S. median
household income, or 188 percent of income for a minimum wage earner,
and is three times the average cost of in-state college tuition.
Full-time in-home care costs range between $25,774 a year in Wisconsin
and $33,366 a year in Washington, D.C.
Nationally, only 11 percent of child care establishments are accredited
by the National Association for the Education of the Young Child or the
National Association for Family Child Care. Accredited child care
centers and family homes range from a low of 1 percent in South Dakota
to a high of 46 percent in Connecticut. In Washington, D.C., 56 percent
of child care establishments are accredited.
Care is most available in Connecticut, Massachusetts, New Hampshire,
Rhode Island, and Vermont. Alaska, Hawaii, Utah, Idaho, and South
Dakota are among the states with the lowest availability of care.
Care is not always available for families who need it. In South Dakota,
all parents work in 82 percent of families with children under 18, the
highest share of working families in the country. Yet the state has
among the lowest availability of care. That suggests that working
families are relying primarily on informal or “gray market” care. Utah
has the lowest share of such working families, but still has a
majority, 63 percent, of all parents working.
One-fifth of families surveyed by Care.com have more than one child
care arrangement, both paid and unpaid, in a typical week.
The short version, then, is that the Care Index found that the early
care and learning system isn’t working. For anyone.
But this is meant to be the beginning, not the conclusion, of this
conversation. The New America Care Report uses the Care Index as a
jumping off point to explore the complexity of the fragmented child
care system. Using the Care Index cumulative scores, we divided states
into quartiles, from highest to lowest, and traveled with a video crew
to one state in each quartile in each region of the country to report
on the consequences of the trade-offs between cost, quality and
availability.
We profile a caregiver in Massachusetts, one of the highest rated
states in the Care Index, who still makes poverty wages and relies on
food stamps after decades doing a job she loves and considers important.
We write about Georgia, in the second quartile, a state that was one of
the first to adopt a universal pre-K program, where infant care is
nevertheless so expensive, low quality and difficult to find that one
family began paying $1,450 a month, on top of the $1,375 for their
three-year-old, just to reserve one of the few spots in a quality
center before their child was even born.
In Illinois, in the third quartile, we tell the story of the owner of a
high-quality Montessori School who, instead of turning away low-income
children when a state budget crisis wiped out funding for child care
subsidies, took out a high risk personal loan.
And in New Mexico, a state with one of the lowest cumulative scores,
the highest rate of child poverty and a growing population of children
who speak a language other than English at home, we show how the high
cost of care has driven many families into the cheaper, informal gray
market.
The New America Care Report proposes systemic change to the early care
and learning infrastructure. (U.S. Department of Education)
The Care Index‘s findings are drawn from a variety of sources including
unique, proprietary Care.com cost data, including the cost of nanny
care, and a new Care.com national survey of more than 15,000 households
with children under 18 in every state conducted in October 2015, as
well as data from the U.S. Census, and the National Association for the
Education of Young Children, among other sources.
The New America Care Report proposes systemic change to the early care
and learning infrastructure, including additional public and private
investment in early care and learning; better training; pay and
professionalization of the teaching workforce; as well as select
innovative policy recommendations to help make high quality care more
affordable and accessible to all families, including:
Universal paid family leave
Expanding and improving cash assistance programs
Implementing high quality universal pre-K programs
Focusing resources on programs aimed at dual-language learners
In 1971, critics who supported a veto against a bipartisan bill that
would have created a high quality, affordable child care system
available to all said they not only wanted to kill the bill, but kill
the very idea of child care in America. They feared a comprehensive
system would force women out of the home and into the workforce, and
rip children from their mothers’ arms to be warehoused. Yet since the
1990s, without the support of any policies, a majority of mothers have
worked outside the home, and a majority of American children have been
cared for by someone other than their mother from the time children
were six weeks old. Studies have found that, contrary to public fears,
child care does not damage children. And that quality early care and
education can have lasting positive impacts, providing a 7 to 10
percent return on investment.The U.S. military invests in and runs the
most effective child care system in the country, seeing it as key to
recruitment, retention and readiness. U.S. businesses cover very little
of the cost of care, 1 to 4 percent by some estimates. Yet absenteeism
and lost productivity due to child care crises cost them about $4
billion a year.
If the child care system isn’t working for anyone, why has there been
no movement for change? In no small part because families, who foot
about 60 percent of the cost of early care and learning, have no time.
They’re too busy trying to find their way in our abysmal child care
system to change it. “It would be the right thing to try to find a
solution,” one family juggling the high cost of care for three children
told us, echoing a theme we heard again and again. “But right now, we
have no choice, we’re just in survival mode.”
A truly comprehensive system would give families real choices for how
to combine their work and home lives. The data and stories in the
Care Index and the New America Care Report are offered as guideposts,
to give families, advocates, providers, teachers and policymakers the
information needed to move beyond survival mode; to get a clearer
picture of where we are and the choices we need to make to move forward
on creating an early care and learning infrastructure that works for
everyone.
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