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States Stretch Child Care Dollars Thin,
Making Care Less Affordable for Families
In a February 1998 study, the HHS Inspector General found that although
experts recommend that poor parents should be required to pay no more
than 10% of their incomes for care, at least 22 States require families who
receive a subsidy to pay a copayment that is higher than 10% of their
incomes.
HHS expects State subsidy programs to reimburse providers at the 75th
percentile of the local market rate, to ensure that families using a subsidy
to pay for care can choose affordable care in the local market. Despite
this recommendation, the HHS Inspector General found that 29 States do
not make payments to providers based on the 75th percentile of the
market rate. In part because of the low reimbursement rates, some
providers require families to pay the difference between the subsidy and
the cost of care, over and above the copayment that the family has paid in
the subsidy program.
QUALITY:
What is Quality?
In the political arena, the definition and measurement of "quality" child care have
been controversial for many years. Nevertheless, child development and child care
experts have identified a range of practical characteristics which indicate child care
quality. Most of these factors are the same ones that would be in place in a safe and
healthy home environment, while others are specifically required because of the nature
of taking care of children in groups, outside of their own homes.
The following are examples of quality factors. This list is illustrative, not
comprehensive or exhaustive.
A Safe Facility
- Cleaning agents and medication out of children's reach
- Playground equipment in good repair
- Sanitary diaper and toileting areas
- Smoke detectors, fire alarms, and posted evacuation plans
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"ocrText": "-5!-\nStates Stretch Child Care Dollars Thin,\nMaking Care Less Affordable for Families\nIn a February 1998 study, the HHS Inspector General found that although\nexperts recommend that poor parents should be required to pay no more\nthan 10% of their incomes for care, at least 22 States require families who\nreceive a subsidy to pay a copayment that is higher than 10% of their\nincomes.\nHHS expects State subsidy programs to reimburse providers at the 75th\npercentile of the local market rate, to ensure that families using a subsidy\nto pay for care can choose affordable care in the local market. Despite\nthis recommendation, the HHS Inspector General found that 29 States do\nnot make payments to providers based on the 75th percentile of the\nmarket rate. In part because of the low reimbursement rates, some\nproviders require families to pay the difference between the subsidy and\nthe cost of care, over and above the copayment that the family has paid in\nthe subsidy program.\nQUALITY:\nWhat is Quality?\nIn the political arena, the definition and measurement of \"quality\" child care have\nbeen controversial for many years. Nevertheless, child development and child care\nexperts have identified a range of practical characteristics which indicate child care\nquality. Most of these factors are the same ones that would be in place in a safe and\nhealthy home environment, while others are specifically required because of the nature\nof taking care of children in groups, outside of their own homes.\nThe following are examples of quality factors. This list is illustrative, not\ncomprehensive or exhaustive.\nA Safe Facility\n- Cleaning agents and medication out of children's reach\n- Playground equipment in good repair\n- Sanitary diaper and toileting areas\n- Smoke detectors, fire alarms, and posted evacuation plans"
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