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October 23, 1997 MEMORANDUM FOR THE SECRETARY OF HEALTH AND HUMAN SERVICES THE SECRETARY OF EDUCATION THE SECRETARY OF THE TREASURY THE SECRETARY OF LABOR THE ATTORNEY GENERAL THE SECRETARY OF AGRICULTURE THE GENERAL SERVICES ADMINISTRATOR SUBJECT: Strengthening Child Care in the United States Parents are the most important people in their children's lives. Studies confirm that fact, but more importantly, parents know it to be true. Each time a parent looks into her son's eyes as he drinks a bottle, or meets her daughter's glance as she scores the winning soccer goal, that parent knows that she matters most to her children. However, child care is a necessity for millions of American families. Millions of children of all income levels are cared for by someone other than their parents every day. Many parents either choose to or need to work outside of the home. Over half of infants under age one are in day care. Twelve million children under the age of six and seventeen million more age six through 13 have both or their only parent in the workforce. Many families in which one parent does not work outside the home also use child-care or early education. Child care has a tremendous impact on the development of our children and on the kinds of citizens we can expect them grow to be. Research shows that children in better quality child care and early education programs have stronger language, pre-mathematics and social skills than those in lower quality settings, and have better relationships with their teachers and more positive self-perceptions. A recent study on the impact of early education on low-income children's development found that good programs can decrease the chances that the child will later commit a crime and increase the chances that the child will succeed in school and earn more as an adult. Child care also has a tremendous impact on our nation's economy. In 1995, 62 percent of women with children younger than six and 77 percent of women with children ages six to 17, were in the labor force. All of these working mothers need someone to care for their children in order to work. A lack of reliable child care can cause workers to lose time or be less productive at work. A 1990 study found that nearly one in six mothers employed outside the home reported losing some time from work during the previous month due to a failure of their regular child care arrangements. I believe that child care is the next great frontier in creating a 21st century social compact that will enable Americans to be good parents and successful workers. There are three key areas that must be addressed: (1) assuring the health and safety of children in child care; (2) helping working families afford child care; and (3) keeping children and youth safe and productive during the hours they are not in school. I, therefore, direct the Secretaries of [....] to report back to me within 45 days with recommendations in the following areas: I. Protecting the Health and Safety of Children by Improving the Quality of Child Care The Facts. The quality of child care in this country is too often merely mediocre or even poor. A recent national study of child care centers found that one in eight centers provide care that is barely adequate -- where children are exposed to unsafe, unsanitary conditions. Infants and toddlers are at the greatest risk, with 40 percent in care that poses a threat to their health and well-being. Only 20 percent of our children are in high quality care -- care that actually enhances growth and development. A study of child care in family-based settings found equally disturbing patterns. Over one-third of programs are rated inadequate, meaning that quality is low enough to harm children's development, and only 9 percent offer high quality care. The people who care for our children are the key to quality. However, the majority of states require no training for child care workers. Child care teaching staff typically earn about $6.50 an hour or a little more than $12,000 per year and often receive no benefits. These conditions results in high turnover, threatening the quality of care. We know that quality matters. Children in poor quality care have been found to have slower cognitive and language development and to show more agression toward other children and adults. On the other hand, good care can improve a child's chances in life, especially if that child comes from a difficult family situation or disadvantaged background. The Goal. By the year 2002, all states should develop and implement strategies to eliminate harmful and substandard care and to ensure that children in child care get what they need to succeed in school and as adults. The Action. Therefore, I direct the Secretary of Health and Human Services to to make recommendations in the following areas: [(A) Develop a fund for states to provide incentive grants to communities that agree to work to toward State benchmarks to improve health, safety and learning of infants and toddlers in child care.] [health outreach, scholarships/loan forgiveness for child care providers, background checks on child care providers, parent education and consumer information] II. Helping Working Families Afford Child Care The Facts. Increasing numbers of working families cannot afford decent child care, which can cost at least $4,000 a year for one child, and even more for infants and toddlers. While the average family pays about 7 percent of its income for child care, child care consumes about a quarter of the income of low-income families who need to pay for child care. The Federal government spent $2.9 billion in direct child care subsidies in fiscal year 1997 -- allowing families to pay for child care for about one million children. However, HHS estimates that we are currently providing child care subsidies for less than a quarter of the families who need them. In addition, the Dependent Care Tax Credit provides more than $2 billion in tax relief for child care expenses. The amount of the creidt has not been adjusted since 1982, despite significant increases in the cost of care over the last 15 years. blyn substan Hally The Goal. By 2002, increase Line # of Fammus who are wble to afford child cure The Action. I direct the Secretary of the Treasury and the Secretary of Health and Human Services to examine the Child Care and Development Block Grant and the Dependent Care Tax Credit: (1) To determine who is being served by each of those funding mechanisms; and (2) To make recommendations about how best to use either or both of them to help working families pay for child care. to increase the # of familier III. Keeping Children Safe and Giving Them Constructive Activities During After School Time The Facts. Many school-age children have parents who work and need safe places to be during out-of-school hours. The lack of an adequate supply of child care leaves many families without access to care. This problem affects families with children of all ages, and is often particularly difficult for those with school-age children. While there are currently 50,000 school age programs serving 1.7 million children across the country, there are more than 16 million school age children in working families. Experts estimate that nearly 5 million children between five and 14 children spend time alone during a typical week. Children who are left unsupervised are at greater risk for school failure as well as alcohol and tobacco use. In addition, juvenile crime rates peak between the hours of three and seven. Research also shows that good activities for school-age children can keep children safe and improve their development and school performance. This is particularly true for low-income children, who are less likely to have access to constructive after-school activities. The Goal. By the year 2002, the number of after-school and summer programs for school-age children should be doubled. The Action. 1 direct the Secretary of Education, the Secretary of Health and Human Services, and the Attorney General [others?] to examine existing programs that serve school-age children and develop a proposal to coordinate funding streams and to reach more children, particularly in low-income, urban areas. [Enough on supply of care? Where put Family Leave/parent choice? Mention children with disabilities] Leanne A. Shimabukuro 10/02/97 08:22:09 PM Record Type: Record To: Jennifer L. Klein/OPD/EOP CC: Jose Cerda III/OPD/EOP Subject: meeting follow up Options from yesterday's meeting: Embrace the principle of background checks for child care workers. There seemed to be some consensus that we should endorse the concept of a pre-employment background check. Maybe this can be done by saying that at a bare minimum, parents and providers should do reference checks on individuals who work with their children. Link Background Checks to CCDBG funds. According to HHS, there is statutory authority to link receipt of CCDBG funds to a new background check requirement similar to the immunization requirement. Pros: No legislation needed; could be a loose "check" requirement that could be met through asking basic questions. Cons: CCDBG funds only serve about 1 million kids; states/ providers would not be happy with new requirement, especially if it is unveiled with immunization rule. Develop and/or Provide Checklist for Background Checks. Some states provide checklists for parents and child care directors with a suggested list of criteria/questions to ask prospective child care providers. Such checklists could be particularly useful for parents that use family day care providers. Pros: Samples may already exist; could make widely available. Cons: Not exhaustive; impact unclear. Highlight Interstate Crime Prevention and Privacy Compact. The interstate compact-- while insufficient as a stand-alone option for the conference-- could be highlighted as an Administration initiative to facilitate better access to state criminal records for background checks on day care workers. Pros: Compact is ready for transmission to Hill; improves access to criminal records for other "non-criminal" purposes as well. Cons: Lengthy process to get Congress and all 50 states to ratify; only addresses access to criminal records. Promote best Practices such as California's Trust Line. Under Trust Line, California does background checks for any child care provider receiving federal funding. The state picks up the tab for the background check. Pros: Pretty obvious. Cons: State cost; only serves low-income families; requires state law(?). An additional Jose idea: create a funding incentive for states to improve their criminal history records and infrastructures and link it to child care background checks. I'm still trying to follow up on this idea with Justice. I'm sure I missed something in my summary. I omitted to include anything about the state abuse registries-- they seem largely problematic for background checks since they usually contain information on children instead of perpetrators. But maybe you caught something I didn't here. Let me know if you need anything else. Thanks. DESSOLORO THE SERISO FACSIMILE TRANSMITTAL SHEET WIDE AND M7SORTIS so SMALL Children's Defense Fund: TELEPHONE: (202) 662-3547 FAX: (202) 662-3560 TO: Jenefer Klein FIRM: CITY/STATE: FAX NUMBER: 456-2878 FROM: HELEN BLANK, Director, Child Care Division, Department of Programs and Policy DATE: 10-1-97 TIME: 3 NUMBER OF PAGES SENT (INCLUDING COVER SHEET): COMMENTS: If you have any problems receiving this fax, please contact Kanya Williams at (202) 662-3544. 15 E Street. 111 11 55001 Ideas to Announce on October 23 The First Lady would join with selected governor's or senators' wives on a bipartisan basis, to have a series of forums before the end of the year to listen to the issues parents (and perhaps providers) face when they look for and have to pay for good child care. These forums would allow her to gather input and anecdotes to support the federal initiative from the ground up and to hear about how child care or the lack thereof affects parents in different parts of the country. It would also present an opportunity to bring in governors' wives and help to focus the issue at the state level. An additional possibility would be, at each stop, for the First Lady and the other dignitaries involved to participate in building a playground at a child care center. This is the child care analogue to Habitat for Humanity. In 1997 and 1998, CDF and Stand for Children have worked with a group called Kabom! that organizes volunteer playground construction. The President would appoint a group of employers to a Commission or working task force which would explore strategies for increasing public and private partnerships to help make child care more affordable, improve the quality, and increase the supply both for the communities in which they operate and for their own employees. This would create an opportunity to bring in some of the lead business figures such as Doug Price in Colorado and the Bennet Bank executive in Florida, who has been so instrumental in the Florida Partnership Program, to propose strategies for upping the ante on the business side of the child care equation. An initiative that builds on Healthy Child Care by connecting child care settings with the new health coverage initiatives--both outreach for Medicaid for eligible children (immediately) and outreach/enrollment in new state child health programs under the August law as the states get rolling. This could be a joint effort of the Child Care Bureau, HCFA, and HRSA. Child care settings could also be sites for Medicaid presumptive eligibility enrollment. This would benefit both children enrolled in child care settings (centers and family child care homes) and providers' children since providers have such low incomes. If the Administration wanted to go beyond health care, child care settings might also be tied into child support enforcement efforts. An announcement that major toy and equipment manufacturers have agreed to join together and contribute toys and equipment to child care centers and family child care homes on a massive basis. Many programs serving low-income children have very limited toys and equipment since rates for care paid by the states do not allow for the costs of purchasing new supplies and equipment. Even programs that do not serve the poorest children struggle to have an adequate supply of toys and equipment, given the limited amount of funds available for child care. Areas for School-Age Programs to Address Programs must offer constructive activities for children to choose between: -Those that help children be successful in school and make responsible choices. -Active physical play to encourage a healthy life style -Arts -Quite activities -Socializing -Enrichment activities such as hobbies Programs must be scheduled to meet the needs of working families. Programs must include staff training and ongoing staff development. Programs must have age appropriate child-staff ratios that allow for frequent interaction between staff and children. Programs must meet appropriate health and safety standards and comply with all applicable codes and regulations. Programs must be available to diverse populations. Programs must be affordable to families: free of charge or on a sliding fee scale basis. Programs must make efforts to have adequate indoor and outdoor space. Draft. Recommendations for a Bi-Partisan Child Care Initiative A bi-partisan Child Care Initiative must assure that all families have access to safe, affordable child care with a focus on infants, toddlers, and school-age children. A stable funding mechanism should be included so that funding is available to reach these goals. 1) Helping Working Families Pay for Child Care Increasing numbers of working families cannot afford the cost of safe and good child care, which can cost at least $4,000 a year for one child, and even more for infants and toddlers. Without some assistance, the cost of decent child care is clearly beyond the reach of many low and moderate income families. For example, half of young families with children earned less than $20,000 in 1994. This affordability issue must be addressed through three strategies: Funding for the Child Care and Development Block Grant should be substantially increased so that by the year 2002, states are able to serve all families with incomes below 85 percent of the state median income. The Dependent Care Tax Credit should be improved so that it better meets the needs of today's families. Specifically: 1) the credit should be refundable; 2) the sliding fee scale should be adjusted to provide increased assistance to the families who need it most; 3) the amount that families can claim should be increased to more realistically reflect the current cost of care; and 4) families who use accredited child care should receive a higher credit (to support the use of better- quality child care). Incentives should be available to encourage the business community to improve and increase child care opportunities for their employees and the communities where they operate. 2) Protecting the Health and Safety of Children by Improving the Quality of their Care and Education Research indicates that nurturing relationships in the early years are critical to a child's positive development and future success. Unfortunately, it also shows that a majority of child care is either mediocre or poor. To address these serious problems, a stronger child care infrastructure is necessary that includes strong licensing standards and enforcement, training, resource and referral. and adequate compensation for child care staff. By the year 2002, all states should have implemented major improvements to eliminate harmful and substandard care and to ensure that children in child care get what they need to succeed in school and as adults. To accomplish this goal, an initiative should include two strategies: Funds should be available to states that choose to implement one or more of the following strategies to strengthen the child care and early education infrastructure: Improved licensing standards and enforcement, including additional staff to monitor and inspect programs to reduce the risk of harm; Increased reimbursement for programs meeting high quality standards; Policies to improve staff compensation and benefits in order to reduce staff turnover; Scholarships for caregivers pursuing a degree in early childhood education; Statewide staff development systems and policies that help to improve training for staff; Targeted funding to enable child care and early education programs to offer comprehensive services through linkages and support from health, social services, and mental health systems; Improved consumer education efforts, including the expansion of local resource and referral programs; and Support to child care and early education programs to use technology, such as long distance learning, more effectively. The Higher Education Act should also be amended to allow loan forgiveness to students who earn degrees in early childhood education and related disciplines and work in child care settings, and to provide targeted support to campus-based child care centers. 3) Keeping Children and Youth Safe and Productive through Better Use of Out-of School Time (School-Age Care) Data suggest that at least 5 million school-age children age 5-14 are home alone after school. Many children who are in care are in settings that do not help them grow and learn. Arrests for juvenile crime peak between 3 and 7 o'clock, and there is some anecdotal evidence that conception of teen pregnancy peaks during these hours as well. Research now proves that school-age children, like children of all ages, develop best in the warmth of close and consistent relationships with adults who can provide safe places and constructive activities during out-of-school hours. These key elements of quality programs are inextricably linked with positive educational and social outcomes for children. Therefore, any initiative should include the following effort: By the year 2002, funds are available to local communities to support before-and after- school, summer, and weekend activities, should be sufficient to serve 5 million children. These activities should be available in a range of settings, including schools, child care settings, homes, and community centers. Resources should be used to start, operate, and expand programs; support staff training, professional development, accreditation, and program assessment and improvement; and facilitate coordination that can make the most of public and private resources. 4) Expanding Good Care for Infants and Toddlers Despite the research showing that the first three years of life are critical to children's development and future success, studies have shown that there are alarming and unacceptable gaps in the supply and the quality of infant and toddler care. A broad child care initiative should include two components to address these problems: Substantial funding should be made available for states to strengthen and enrich programs serving very young children, as well as increase support to parents of young children and other caregivers. Specifically, funds should be available for activities such as: Operating family child care networks which serve infants and toddlers; Expanding the supply of infant and toddler care, especially for care that is in short supply; Supporting initiatives to increase the compensation of caregivers caring for very young children; Providing specialized training for caregivers working with infants and toddlers; Expanding resource and referral programs; Assisting programs serving young children in becoming accredited; Helping child care programs serving young children to allow them to link with other essential services in the community; and Providing parenting education and support programs. The Family and Medical Leave Act should be expanded to cover more work places and employees, and to provide leave for a broad range of family needs. Strong family leave policies are critical, as they enable working parents to stay home during the critical early months of a child's life or when a child is seriously ill, and to play an active role in their children's early development. 5) Continuing Support for Head Start and the Child and Adult Care Food Program Head Start is an essential component of any initiative to strengthen families' access to strong early learning experiences. The Head Start reauthorization should continue the program on its path toward serving all eligible children. It should also recognize the growing need to reach younger children by expanding funds available for Early Head Start. The reauthorization of the Child and Adult Care Food Program (CACFP) should make it possible for for-profit child care centers serving low-income children to participate in CACFP, allow programs to serve school-age children up to age 18, and restore the option of a fourth meal or snack for children spending extended hours in child care centers and family child care homes. Draft Ideas for Outreach for Child Care Conference 1. Technical correction / amendment: Medicaid matches outreach for children whose parents are moving from welfare to work at 90 percent (up to the TANF $500 million limit). The use of this money could be broadened to cover all uninsured children eligible for either Medicaid or the new program. 2. Clarification of previous guidance: - Presumptive eligibility: Any site that receives Medicaid funding for outreach can also determine presumptive eligibility - State plan template: Add that a state report if and how it uses child care and school settings for outreach 3. New guidance: Define Medicaid coordination to mean: - Single application for Medicaid and new program or - Joint distribution of both applications with intake for both programs at the same sites (coordinated through an interagency agreement) 10/05/97 SUN 17:45 FAX 001 XXX MEMORANDUM FOR THE SECRETARY OF HEALTH AND HUMAN SERVICES THE SECRETARY OF EDUCATION THE ATTORNEY GENERAL THE SECRETARY OF THE TREASURY THE SECRETARY OF AGRICULTURE THE SECRETARY OF LABOR THE GENERAL SERVICES ADMINISTRATOR SUBJECT: Strengthening Child Care in the United States America's working families deserve our support and assistance I am committed to addressing improving child care for the millions of working families who need and rely on it. Child care is a critical component of school readiness, child development I believe that in order for our nation to enter the twenty-first Century as strong as we need to be. we most address child care I am therefore committed to making commitments in three critical areas -- protecting the health and safety of children by improving the quality of child care in our nation; I. Protecting the Health and Safety of Children by Improving the Quality of Child Care in Our Nation No parent should worry that their child is healthy and safe in child care. Studies tell us that many children are in child care that does not make the grade, and that some are in settings that compromise their health and safety. Link to school readiness. We must work with states to eliminate harmful and substandard care and to ensure that children in child care get what they need to succeed in school and become productive citizens. Today, therefore, I direct: The Secretary of Health and Human Services to report TO me within 60 days with a specific proposal to establish incentive grants for states to make specific quality improvements in child care delivery, including but not limited to: --Improving licensing standards and enforcement; 10/05/97 SUN 17 45 FAX 002 -Assisting child care settings meet accreditation or liscensing standards; --Instituting home visiting for family child care providers; --Operating family child care networks which serve infants and toddlers; --Providing training opportunities to child care providers; --Helping child care programs link with other essential services in the community; and --consumer child care education We know that the child care provider is key to quality. We must support those that are good, and weed out those that are not. Today, therefore, I hereby establish a Child Care Provider Day, to be observed on April 24, 1998, in recognition of the important work of child care providers. Furthermore, today I direct: The Secretary of Heath and Human Services and the Secretary of Education to report to me within 60 days with specific proposals to promote the training of child care providers, including but not limited to: -Establishing a scholarship fund for child care providers --Instituting loan forgiveness for child care providers who are committed to staying in the field --Outreach to child care providers on current grants available to them, such as the Pell Grant. As we support our dedicated child care providers, we must likewise ensure that only those who are fit to care for our children enter this profession. Today, therefore I direct: The Attorney General and XXX to XXX Another key to quality is parent education and consumer information. We must equip parents to make informed choices about the child care that is best for their children. Today, therefore, 1 direct: The Secretary of Health and Human Services to report to me within 60 days with a specific proposal to undertake a public awareness campaign targetted to America's working parents on what to look for in child care. II. Helping Working Families Pay for Child Care Low-income working families cannot afford child care without assistance Welfare to work. 17:45 FAX 003 Subsidies do not reach enough working families. Quality costs more. Today, therefore, I direct: The Secretary of Health and Human Services and the Secretary of the Treasury to report to me within sixty days with a specific proposal to provide assistance to (twice the #, "more", all who are eligible by 2002 ...). (Nothing on DCTC?) Many American businesses provide child care benefits and assistances to their employees. We must encourage and foster this. Today. therefore, by Executive Order XXX, I have established a Child Care Business Advisory Commission, to report to the Secretary of the Treasury, on ways to encourage businesses to join this national effort to improve child care. III. Keeping Children and Youth Safe and Productive through Good Use of Out-of-School Time Far too many of America's children and youth are alone after school. FBI studies -- link of programs to safety of children and drop in juvenile crime. Link of good programs to better performance in school. Today, therefore, I direct: The Secretary of Education, the Attorney General and the Secretary of HHS to report to me within sixty days on efforts to: --coordinate on the federal level the programs that target after-school, community-based efforts. --expand the number of communities that federal government supports by IDEAS ON LINKING CHILD CARE AND CHILDREN'S HEALTH INSURANCE INFORMATION ON INSURANCE OPTIONS Given the passage of the children's health insurance initiative, there are more opportunities than ever for children to receive affordable health insurance. However, families may not know about their options. One of our first tasks is making this information available and accessible. 1. Informational brochure [us; HHS]: Develop simple material for distribution both at the conference and to child care workers on what the initiative is. information on Medicard 2. Coordinate applications for Medicaid and new kids programs President/Secretary engibility. letter to Governors]: The new law requires that when a child applies for the new program but is found eligible for Medicaid, that child is enrolled in Medicaid. We could tell states that they are in compliance with the law if they do one of two activities: Use a single application Distribute both types of applications together and have an interagency agreement (if there are separate agencies) so that applications for Medicaid and the new children's health plan may be accepted at the same sites and sent to the appropriate agency. This will make it easier for child care workers, school nurses, and community groups to conduct outreach for both the new program and Medicaid. In addition, we could remind states that we have a model, simple application, and distribute sample applications that are simple (e.g., South Carolina's). 3. Coordinate child care and health benefits [Public/private partnership or interagency group]: The Robert Wood Johnson Foundation has sponsored the use of a Bully single, user-friendly brochure describing benefit available to low-income families, pulpit including Medicaid, child care subsidies, EITC, and food stamps. They also have a video [we are getting this on Tuesday]. This appears to be successful in educating families outside of the social services offices. 4. Nationwide information outreach campaign [Public/private partnership]: Announce an effort to work with foundations, business and states to (1) develop user-friendly information on state insurance options; (2) a 1-800 number to direct families to their local Partnership to get offices for applications; and (3) possibly launch a national media campaign to make out information. families aware of their options. [Since states are just developing their plans, we could Businesses, Foundations make this more of an announcement of intention -- getting the NGA, a couple NGA, Fed. Gov't foundations, and a couple businesses to agree and work on a large announcement of what this would be in the winter or spring] USE OF CHILD CARE CENTERS AND SCHOOLS Once information on options has been developed, it needs to be put in the places where children are: child care sites for younger children and schools for older children. 5. Medicaid handbook for child care workers [HHS]: [Jen: this is underway at HHS -- for the conference?] 6. Required description of the use of child care and school settings in child health plan President/Secretary letter to Governors]: Under the new law, states will submit for approval a "child health plan". We could announce that we will ask states to describe if and how they are providing information and applications to eligible families through child care centers and schools in the state plan submission. 7. Clarification of the important role that child care centers and schools may have in health insurance outreach President/Secretary letter to Governors]: Under current law, for both Medicaid and the new children's program, child care centers and schools What's action the can distribute information and applications, assist in filling out applications, receive funding for such activities, and, under some circumstances, enroll children in these program. Outreach activities for low-income children may be matched by the Federal government at 90 percent up to a limit ($500 million of TANF funds). While all of these activities are possible, there is no single statement of how all of these pieces come together, so that we could somehow communicate that these options are available. 8. Commitment to teach child care workers and school nurses to education and enroll children [Public/private partnership]: Announce an agreement of the CCRR group, school nurse group, NGA and us to work together to make these sites keys to getting uninsured children into the system. EXAMPLES Single, simple brochure for Medicaid, child care, EITC and Food Stamps: We have examples for FL, GA, NC, TN; also a 4 minute video talking about the coordination of benefits. We also have a lot of simple Medicaid applications. Alliance for South Carolina's Children: I think that this is primarily a child care group that is very active with health insurance; need to check. Washington: Members of CCRR are trained to screen callers for Medicaid eligibility and send them the state's one-page, mail-in application form and basic program information. Baltimore: LOCATE, a statewide child care resource and referral agency, assess its callers' eligibility for Medicaid and mails them applications if they appear to be eligible. The organization also providers Medicaid information to all licensed child care programs. Alabama: One CCRR in Opelika has trained its staff counselors to help parents complete the short, mail-in Medicaid application at the same time as the child care application. P.01 OCT-09-97 THU 09:22 AM Call Joan THE FEDERAL PELL GRANT PROGRAM Program Summary Federal Pell Grants are designed to help the neediest undergraduate students gain access to higher education. Pell Grants do not need to be repaid. In 1995-1996, the Federal Pell Grant program provided grants totaling $5.5 billion to over 3.6 million students. In the fiscal year 1998 budget, the President has requested an increase in the Pell Grant maximum award to $3,000 that will provide $7.6 billion to over 4 million students for 1998-99. Eligibility To be eligible to receive a Pell Grant, a student must be a U.S. citizen or permanent resident, be enrolled in an eligible program at a school participating in the Federal Pell Grant Program, and be determined to have sufficient financial need. Students enrolled less than half time may receive Pell Grants, but the amount of their grants will be less than if they were enrolled full time. Students must be enrolled in programs that are 6 months or longer to receive a Pell Grant. A student is eligible to receive Pell Grants for as long as is required to complete his first baccalaureate degree as long as he or she maintains satisfactory academic progress. In general, an eligible student may receive only one Pell Grant per award year. Grant Amounts An eligible student's award size depends on need, cost of attendance, whether he attends full-time or part-time, and whether he attends for a full academic year or less. Financial need = cost of attendance - expected family contribution (EFC). The calculation of EFC considers the student's income, assets, and family size. The amount of a student's Pell Grant increases as his EFC decreases. A student with a minimum EFC of zero may receive the maximum award equal to the applicant's educational cost for the year. The maximum Pell Grant award in 1997-1998 is $2,700; the minimum was $400. OPTIONAL FORM 90 (7.90) FAX TRANSMITTAL 8 of pages 2 To Jon Kleir FOR David Beyers Phone # Dept/Agency Fax # Fax 456-2878 3099-101 GENERAL SERVICES ADMINISTRATION NSN 7510-01-317-7368 OCT-09-97 THU 09:22 AM P. 02 Pell Grants and Early Childhood Education In 1995-96 (the latest year for which data is available), an estimated 100,000 undergraduate students were enrolled in early childhood education, or approximately 1/2 of 1 percent of the total number of undergraduate students. Early childhood education includes individuals training to be child care workers as well as pre-school and elementary school teachers. Of those studying early childhood education, approximately 56 percent received I thought student financial aid with 27 percent receiving a Pell Grant compared to all then undergraduates 50 percent of whom received aid with 22 percent receiving Pell know Grants. Of those studying early childhood education, 28 percent were enrolled full-time for the full academic year; 11 percent were enrolled full-time for part of the academic year; 20 percent were enrolled part-time for the full academic year; and 41 percent were enrolled part-time for part of the academic year. Of those enrolled full-time for the full academic year in early childhood education, approximately 65 percent received student financial aid with 1/3 receiving a Pell Grant compared to other similarly enrolled undergraduates 68 percent of whom received aid with 30 percent receiving Pell Grants. Of those enrolled part-time for the full academic year, in early childhood education, approximately 61 percent received financial aid with 38 percent receiving a Pell Grant. compared other similarly enrolled undergraduates, 45 percent of whom received aid with 19 percent receiving Pell Grants. NOTE: THE DATA PRESENTED ABOVE ARE PRELIMINARY AND MAY NEED TO BE REFINED PRIOR TO PUBLIC RELEASE. CHCA RE O12 Page 1 IDEAS ON LINKING CHILD CARE AND CHILDREN'S HEALTH INSURANCE A. Simplifying Outreach for Medicaid & the Children's Health Insurance Program (CHIP): The President could send a letter to Governors that clarifies: 1. Health program coordination: Inform states that they must either use a single application or distribute Medicaid and CHIP applications jointly (with applications accepted at the same site) to meet the statutory requirement that they coordinate the two programs. This will make it easier for child care workers and school staff to educate children and their families about their options and help them to enroll. [new CHIP policy guidance] 2. State plan description of the use of child care and school sites for outreach: Inform states that they must include in their state child health plans for Title XXI a description of if and how they will use these sites to educate and enroll children. This will hopefully encourage states to work with these sites. [new CHIP policy guidance] 3. "Presumptive eligibility" in child care and school setting: On October 10, a letter was sent to State Medicaid Directors stating that only listed "entities" such as child care centers that also determine eligibility for child care subsidies may give a child Medicaid coverage while waiting for the application to be processed (presumptive eligibility). However, if a child care center or school receives funding from the state for Medicaid outreach activities, it may also grant presumptive eligibility. [clarification of previous CHIP policy guidance] 4. Outreach payment: In CHIP, the Federal government will match the costs of outreach, administration, and direct services up to a limit of 10 percent of the state's Federal allotment. We could broaden the availability of outreach funds by (1) correcting the law to make the 10 percent applicable to total not just Federal spending (a technical correction); (2) making Medicaid the primary payer for outreach. Medicaid matches outreach for certain children at 90 percent (up to the TANF $500 million limit) with neither a limit on the total amount available (10% in CHIP) nor competition with other administrative and direct services costs. [probably requires an amendment to Title XXI] B. Enlisting child care providers, school nurses and teachers in outreach: Develop an agreement to work with these associations to get them the information that they need to educate and assist families in insuring their CHCARE O12 Page 2 children. 1. Medicaid handbook for child care workers [HHS]: [need to check] 2. Informational brochure [us; HHS]: Develop simple material for distribution both at the conference and to child care workers on what CHIP is. BACKUP Nationwide information outreach campaign [Public/private partnership]: Announce an effort to work with foundations, business and states to (1) develop user-friendly information on state insurance options; (2) a 1-800 number to direct families to their local offices for applications; and (3) possibly launch a national media campaign to make families aware of their options. [Since states are just developing their plans, we could make this more of an announcement of intention -- getting the NGA, a couple foundations, and a couple businesses to agree and work on a large announcement of what this would be in the winter or spring] Coordinate child care and health benefits [Public/private partnership or interagency group]: The Robert Wood Johnson Foundation has sponsored the use of a single, user-friendly brochure describing benefit available to low-income families, including Medicaid, child care subsidies, EITC, and food stamps. They also have a video [we are getting this on Tuesday]. This appears to be successful in educating families outside of the social services offices. EXAMPLES Single, simple brochure for Medicaid, child care, EITC and Food Stamps: We have examples for FL, GA, NC, TN; also a 4 minute video talking about the coordination of benefits. We also have a lot of simple Medicaid applications. Alliance for South Carolina's Children: I think that this is primarily a child care group that is very active with health insurance; need to check. Washington: Members of CCRR are trained to screen callers for Medicaid eligibility and send them the state's one-page, mail-in application form and basic program information. Baltimore: LOCATE, a statewide child care resource and referral agency, assess its callers' eligibility for Medicaid and mails them applications if they appear to be eligible. The organization also providers Medicaid information to all licensed child care programs. CHCARE.012 Page 3 Alabama: One CCRR in Opelika has trained its staff counselors to help parents complete the short, mail-in Medicaid application at the same time as the child care application. October 14, 1997 MEMORANDUM TO BRUCE REED ELENA KAGAN FROM: JENNIFER KLEIN NICOLE RABNER CC: MELANNE VERVEER RE: POLICY OPTIONS FOR CHILD CARE CONFERENCE As you know, we plan to have the President announce two or three small policy initiatives at the White House Conference on Child Care as "downpayments" on our larger child care agenda. This memorandum outlines the policy options that we are considering. Working Group of Business Leaders. The President would appoint Secretary Rubin to co-chair, with a private sector executive, a working group of business leaders on child care. The group would report back within 60 days on strategies for developing public-private partnerships to improve the quality and affordability of child care. We are working with Treasury to set up the working group and to appoint a co-chair who could be announced at the conference. HHS and Treasury support doing this, as do many child care advocates and experts. Treasury has raised some concern that the group might make recommendations that the Administration is not prepared to accept. With those concerns in mind, we have narrowly defined the scope of their work. Health Outreach in Child Care Centers. The President would announce a plan to enroll eligible children in child care centers in Medicaid or the new state children's health program. This would build on the Administration's commitment to linking health care and child care through the Healthy Child Care America Campaign, which promotes safety and healthy development in child care and improves access to immunization, nutrition and other health services in child care settings. We are working with Chris Jennings and Jeanne Lambrew on a series of proposals, including: Clarifying regulations to ensure that child care centers and schools distribute information about these health programs, assist in filling out applications, and grant presumptive eligibility for Medicaid. 1 Requiring states in their state plans for the children's health program to describe how they will use child care centers to enroll children. Developing an agreement with child care providers, school nurses and teachers to work together on education and outreach to families. This would include release of a Medicaid handbook for child care workers (currently being produced at HHS) and a simple brochure describing the new children's health program. Chris and Jeanne will discuss any health care proposals with the National Governors Association staff to ensure that states will support our policy. Scholarships for Child Care Workers. The President would announce a new federal scholarship program for child care workers. We are waiting for a final proposal from the Department of Education (DOE). Our suggestion had been to announce our support for Senator DeWine's "Quality Child Care and Loan Forgiveness Act" that provides loan forgiveness for students in early childhood education programs. The bill allows 15% of the total amount of a loan to be forgiven for each year of employment and requests an appropriation of $10 million for fiscal year 1998. Senator Kerry has a similar loan forgiveness bill that requests an appropriation of $100 million for 1998. DOE is opposed to granting loan forgiveness to people entering particular professions, so the Department is developing an alternative proposal. The President would also announce an outreach plan to let students in training to become child care workers know that many of them are currently eligible for Pell Grants. Announcing policy in this area at the conference makes sense given strong agreement that the key to quality child care is the provider. A proposal would receive strong support from the child care and labor communities. However, we obviously need to resolve remaining issues with Education and to involve OMB and NEC before going forward. Background Checks on Child Care Workers. This announcement could have three parts. First, the President would release a Department of Health and Human Services "checklist" of questions that employers and parents could use in interviewing and doing reference checks on child care providers. The ABA Center on Children and the Law recently completed a study finding that employer reference checks and personal interviews are among the most effective ways to screen child care providers. The Center also reports that 98 percent of respondents conduct personal interviews and 93 percent check references with past employers. However, there is no assurance that these checks 2 are done right. The "checklist" would arm parents and employers with the information they need to do proper and thorough screening. Second, HHS would issue regulations requiring any child care center receiving federal funding through the Child Care and Development Block Grant (CCDBG) to use the "checklist." HHS has authority to do this under provisions of the CCDBG allowing them to regulate health and safety in three specific areas (building and premises safety, training, and health and infectious diseases, including immunization). As you know, HHS recently issued regulations under this authority requiring federally-funded centers to ensure that the children in their care are properly immunized. Third, the President would urge Congress to pass and the states to join the Interstate Crime Prevention and Privacy Compact. This compact, which is ready for transmission to the hill, would give access to criminal records for non-criminal purposes, including background checks on child care providers. While a slow and lengthy process, this would give the President an opportunity to talk about the importance of making this information available so that children in America will no longer threatened by the few "bad apple" child care workers. These announcements are controversial for several reasons. Secretary Shalala strongly believes that we should not take any steps in this area at the conference, and is particularly opposed to issuing HHS regulations. Because of the uproar by the states after HHS issued the immunization regulations, Shalala is adamantly opposed to any action in this area. More generally, she is concerned that we will give the impression that we do not support child care providers -- who as a whole work hard, receive meager salaries, and work in difficult conditions. In addition, she believes that announcing a controversial policy at the conference will jeopardize our ability to accomplish our larger child care agenda. 3 CENTER ON BUDGET AND POLICY PRIORITIES TO: Sally K. Richardson, Acting Deputy Administrator, HCFA FROM: Donna Cohen Ross, Director of Outreach, CBPP Cindy Mann, Director, State Low-Income Initiatives Project, CBPP DATE: July 14, 1997 RE: Encouraging State Medicaid Agencies to Facilitate Enrollment of Eligible Children in Medicaid Thank you for meeting with us to talk about Medicaid outreach issues. We appreciated your time and your genuine concern about the challenges we all face in ensuring that all eligible children have the opportunity to obtain Medicaid benefits. As we discussed, the major challenges are in three areas: disseminating accurate information to families on Medicaid eligibility, making the application process simpler and more accessible, and preventing a decline in Medicaid enrollment as a result of welfare program changes. Your suggestion that HCFA could convene regional workshops for state Medicaid staff and other interested parties to address issues related to facilitating the enrollment of uninsured children would be very helpful. A "how-to" session that describes the concrete steps states can take to simplify the Medicaid application process - as well as one that examines the interaction between TANF and Medicaid and considers how the enrollment processes can be coordinated - would provide a framework for states to improve their current systems. We would be happy to help make such meetings as informative and productive as possible. In addition to arranging technical workshops, we hope HCFA will consider issuing written guidance to state Medicaid directors reinforcing their authority under current law to streamline the application process. Such guidance can assure states that HCFA supports efforts to conduct effective outreach activities. Disseminating samples of simplified applications currently in use can further demonstrate that states' efforts to shorten application forms or reduce verification requirements would not result in quality control sanctions. HCFA also could use this opportunity to highlight the availability of new administrative funds allocated by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA) for outreach activities. Finally, the existence of written guidance on outreach, would give many community organizations the confidence to approach their state Medicaid agencies to initiate partnerships for conducting outreach activities. Considerations for Medicaid Outreach Public attention has been focused on the three million children who are eligible for Medicaid, yet remain uninsured. Our recent analysis of Census data found that these children are likely to be in working families not receiving cash assistance. Moreover, the "delinking" of eligibility for cash assistance and Medicaid, resulting from the implementation of the PRWORA of 820 First Street, NE, Suite 510, Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 [email protected] http://www.cbpp.org HN0026 1996, and other welfare program changes, are likely to result in an increase in the number of children who are eligible for Medicaid but who are not enrolled. While providing accurate information about Medicaid eligibility is an important way to help reduce the numbers of uninsured children, it is only a first step. Unless outreach efforts are linked to the Medicaid application process the job is only partly done. Designing a Medicaid application process that is simple and accessible in community settings is essential. Through the Center's Start Healthy, Stay Healthy project, which enlists early childhood programs and other community-based organizations in efforts to identify and to enroll eligible children in Medicaid, we have learned a great deal about how the Medicaid application process can help or hinder efforts to facilitate enrollment. Applications need to be as short and simple as possible, with the least burdensome verification requirements. It also is important to ensure application forms are translated into languages commonly spoken in the community. Since the constraints on parents working in low-paying jobs, who often do not have the flexibility to leave work to apply at a Medicaid office, and the difficulties faced by families who may not have access to transportation often pose serious barriers to Medicaid participation, it is very helpful to allow applications to be submitted by mail. Establishing Medicaid outstations in a variety of community-based settings also helps assure that the Medicaid application process is accessible. While the staff of the outstation site can conduct initial processing of applications, it also is helpful to have a sufficient number of state eligibility workers who can be assigned to outstations or who can rotate among several locations so that eligibility determinations can be made on site. Activities HCFA Could Promote There is no specific formula for ensuring that all children who are eligible for Medicaid are enrolled in the program. For some families, a clearly-worded brochure explaining how to obtain health insurance for their children is enough to encourage them to apply. For others, the availability of a mail-in application will be a key factor in whether they apply or not. Still others will need the help of an community outreach worker who speaks their language at a local outstation site. By taking the following steps, states can ensure that the tools are in place to facilitate enrollment in a variety of settings. 1. Shorten and simplify the Medicaid application. Medicaid applications can be long and complicated. Verification requirements can be onerous, as well. Applicants who have trouble gathering the required documents can be denied Medicaid even though they are eligible. Shorter applications have a number of advantages. For example, they are likely to require fewer documents to verify the information on the application. Simplified applications also make outstationing sites more effective and allow staff of community-based organizations to play a direct role in assisting families in navigating the application process. Simple applications also promote a more positive image for the Medicaid program. HCFA has issued a four-page model application form. Twenty-eight states currently use applications that are the same length or shorter than the HCFA model. Not all of these short applications are as simple as they could be, but several of them could serve as models for states interested in shortening their current applications. 2. Eliminate the assets test used to determine eligibility for Medicaid for pregnant women and children. Thirty-four states and the District of Columbia have dropped the assets test in determining Medicaid eligibility for children. An additional three states no longer count assets for some poverty level children. Dropping the assets test is one way to simplify the Medicaid application and minimize the verification burden. 3. Allow applicants to submit their completed applications through the mail; encourage community organizations to keep mail-in forms on hand to distribute to families. For working parents or residents of rural areas, making a trip to the Medicaid office can be difficult or costly. Medicaid offices often are open only during regular work hours and overcrowding may cause long waits for service. Community-based organizations and institutions can provide the mail-in applications to families interested in applying for Medicaid for their children, along with basic information about Medicaid eligibility and a list of the documents required to verify the information on the application. States that conduct training on the basics of the Medicaid program for staff of community organizations can assure that families are receiving proper information and appropriate guidance on how to proceed with the application process. In addition to allowing applications to be submitted by mail, there needs to be a system in place for receiving and processing such applications in a timely and efficient manner. Currently, 22 states and the District of Columbia allow Medicaid applications to be submitted by mail. Of these, 15 do not require a personal interview; the remaining 8 will allow an interview to be conducted by telephone. 4. Expand the use of Medicaid "outstations" to include settings other than disproportionate share hospitals and community health centers, that are required by law. Regulations pertaining to outstationing indicate that states may consider other locations, such as family support centers and school-linked service centers, that are frequently visited by the targeted populations. The enhanced federal matching funds for administrative costs resulting from welfare reform, announced in the Federal Register on May 14, 1997, designates as a priority activity outstationing eligibility workers at other feasible locations such as WIC clinics, child care programs and churches. 5. Contract with community-based groups to conduct Medicaid outreach and enrollment activities. Community-based organizations are a tremendous resource and can make important contributions to a state Medicaid outreach effort. They can help develop and disseminate outreach materials, assist families in completing Medicaid applications, host and help staff community-based Medicaid outstations. Administrative funds designated for outreach activities can make productive partnerships with community organizations possible. Promising Outreach Strategies for the Future While the final provisions in this year's reconciliation bill are not yet determined, two new options that could significantly expand Medicaid coverage for children may be included in the new law. One provision would allow child health providers, Head Start programs, WIC clinics and agencies that determine eligibility for subsidized child care to presumptively enroll children into the Medicaid program. This option could assure that children receive health care without experiencing a delay caused by the time it takes to process a Medicaid application. Allowing child care, Head Start and WIC sites to make presumptive eligibility determinations has other benefits as well. These programs have frequent contact with working families and are trusted by those families for advice about child health issues. In addition, these programs are often set up to accommodate the needs of working parents. A GAO study ("Prenatal Care: Early Success in Enrolling Women Made Eligible by Medicaid Expansions", February 1991) examined ten states that implemented various options to expand Medicaid to pregnant women. The study found states that simultaneously implemented presumptive eligibility and dropped the assets test used in determining Medicaid eligibility experienced the most rapid growth in enrollment. Since a majority of states have already dropped the assets test for children, presumptive eligibility is likely to provide the "missing link" needed to improve Medicaid enrollment rates among children. The second new option would allow states to enroll children for 12-month continuous periods, without regard to changes in family circumstances. The option would help stop some of the churning of cases that now occurs within the Medicaid program, allowing children access to more stable coverage. This option should be favored by states moving to managed care delivery systems, as it guarantees 12-months of enrollment to managed care companies and would facilitate plans' ability to deliver the primary and preventive care benefits that managed care promises to children. In the event that these new options become law, we hope that HCFA would add them to the list of recommended outreach strategies and encourage states to adopt them. We hope you will find these ideas worth pursuing. If it would be helpful to include descriptions of some of the Medicaid outreach activities currently underway in communities around the country, we would be happy to provide some examples. If you would like to discuss any of these ideas further, please do not hesitate to call us at the Center on Budget and Policy Priorities, (202) 408-1080. Thanks for your concern about these important issues. October 14, 1997 MEMORANDUM TO BRUCE REED ELENA KAGAN FROM: JENNIFER KLEIN NICOLE RABNER CC: MELANNE VERVEER RE: POLICY OPTIONS FOR CHILD CARE CONFERENCE As you know, the President will announce two or three small policy initiatives at the White House Conference on Child Care as "downpayments" on his larger child care agenda (which will be outlined in an Executive Memorandum issued at the conference). This memorandum outlines the policy options that we are considering. Working Group of Business Leaders. The President would appoint Secretary Rubin to co-chair, with a private sector executive, a working group of business leaders on child care. The group would report back within 60 days on strategies for developing public-private partnerships to improve the quality and affordability of child care. We are working with Treasury to set up the working group and to appoint a co-chair who could be announced at the conference. HHS and Treasury support doing this, as do many child care advocates and experts. Treasury has raised some concern that the group might make recommendations that the Administration is not prepared to accept. With those concerns in mind, we have narrowly defined the scope of their work. Health Outreach in Child Care Centers. The President would announce a plan to enroll eligible children in child care centers in Medicaid or the new state children's health program. This would build on the Administration's commitment to linking health care and child care through the Healthy Child Care America Campaign, which promotes safety and healthy development in child care and improves access to immunization, nutrition and other health services in child care settings. We are working with Chris 1 Jennings and Jeanne Lambrew on a series of proposals, including: Clarifying regulations to ensure that child care centers and schools distribute information about these health programs, assist in filling out applications, and grant presumptive eligibility for Medicaid. Requiring states in their state plans for the children's health program to describe how they will use child care centers to enroll children. Developing an agreement with child care providers, school nurses and teachers to work together on education and outreach to families. This would include release of a Medicaid handbook for child care workers (currently being produced at HHS) and a simple brochure describing the new children's health program. Chris and Jeanne will discuss any health care proposals with the National Governors Association staff to ensure that states will support our policy. Scholarships for Child Care Workers. The President would announce a new federal scholarship program for child care workers. Our suggestion had been to announce our support for Senator DeWine's "Quality Child Care and Loan Forgiveness Act" that provides loan forgiveness for students in early childhood education programs. The bill allows 15% of the total amount of a loan to be forgiven for each year of employment and requests an appropriation of $10 million for fiscal year 1998. Senator Kerry has a similar loan forgiveness bill that requests an appropriation of $100 million for 1998. DOE is opposed to granting loan forgiveness to people entering particular professions, so the Department is developing an alternative proposal either through adult and vocational education or school-to-work. HHS also requested an increase of $150 million for FY 1999 in the CCDBG to model a scholarship program after North Carolina's T.E.A.C.H. Program. The President would also announce an outreach plan to let students in training to become child care workers know that many of them are currently eligible for Pell Grants. Announcing policy in this area at the conference makes sense given strong agreement that the key to quality child care is the provider. A proposal would receive strong support from the child care and labor communities. However, we obviously need to resolve remaining issues with Education and HHS and to involve OMB and NEC before going forward. 2 Background Checks on Child Care Workers. This announcement could have three parts. First, the President would release a Department of Health and Human Services "checklist" of questions that employers and parents could use in interviewing and doing reference checks on child care providers. The ABA Center on Children and the Law recently completed a study finding that employer reference checks and personal interviews are among the most effective ways to screen child care providers. The Center also reports that 98 percent of respondents conduct personal interviews and 93 percent check references with past employers. However, there is no assurance that these checks are done right. The "checklist" would arm parents and employers with the information they need to do proper and thorough screening. Second, HHS would issue regulations requiring any child care center receiving federal funding through the Child Care and Development Block Grant (CCDBG) to use the "checklist." HHS has authority to do this under provisions of the CCDBG allowing them to regulate health and safety in three specific areas (building and premises safety, training, and health and infectious diseases, including immunization). As you know, HHS recently issued regulations under this authority requiring federally-funded centers to ensure that the children in their care are properly immunized. Third, the President would urge Congress to pass and the states to join the Interstate Crime Prevention and Privacy Compact. This compact, which is ready for transmission to the hill, would give access to criminal records for non-criminal purposes, including background checks on child care providers. While a slow and lengthy process, this would give the President an opportunity to talk about the importance of making this information available so that children in America will no longer threatened by the few "bad apple" child care workers. These announcements are controversial for several reasons. Secretary Shalala strongly believes that we should not take any steps in this area at the conference, and is particularly opposed to issuing HHS regulations. Because of the uproar by the states after HHS issued the immunization regulations, Shalala is adamantly opposed to any action in this area. More generally, she is concerned that we will give the impression that we do not support child care providers -- who as a whole work hard, receive meager salaries, and work in difficult conditions. In addition, she believes that announcing a controversial policy at the conference will jeopardize our ability to accomplish our larger child care agenda. 3 POLICY ANNOUNCEMENTS FOR CHILD CARE CONFERENCE October 14, 1997 As you know, the President will announce two or three small policy initiatives at the White House Conference on Child Care as "downpayments" on his larger child care agenda. This memorandum outlines those policy options. Working Group of Business Leaders. The President would appoint Secretary Rubin to co-chair, with a private sector executive, a working group of business leaders on child care. The group would report back within 60 days on strategies for developing public-private partnerships to improve the quality and affordability of child care. We are working with Treasury to set up the working group and to appoint a co-chair who could be announced at the conference. HHS and Treasury support doing this, as do many child care advocates and experts. Because Treasury raised some concern that the group might make recommendations that the Administration is not prepared to accept, we are working with Treasury on the scope of their work. Loan Forgiveness for Child Care Workers. The President would announce his support for Senator DeWine's and (maybe also) Senator Kerry's loan forgiveness bills. Senator DeWine's bill allows 15% of the total amount of a loan to be forgiven for students in early childhood education training programs each year of employment and requests an appropriation of $10 million for fiscal year 1998. Senator Kerry's loan forgiveness bill requests an appropriation of $100 million for 1998. The President would also announce an outreach plan to let students in training to become child care workers know that many of them are currently eligible for Pell Grants. Background Checks on Child Care Workers. This announcement could have two parts. First, the President would release a Department of Health and Human Services "checklist" of questions that employers and parents could use in interviewing and doing reference checks on child care providers. The ABA Center on Children and the Law recently completed a study finding that employer reference checks and personal interviews are among the most effective ways to screen child care providers. The Center also reports that 98 percent of respondents conduct personal interviews and 93 percent check references with past employers. However, there is no assurance that these checks 1 are done right. The "checklist" would arm parents and employers with the information they need to do proper and thorough screening. Second, the President would submit legislation to Congress on the Interstate Crime Prevention and Privacy Compact and urge Congress to pass and the states to join the compact. This compact would give access to criminal records for non-criminal purposes, including background checks on child care providers. While a slow and lengthy process, this would give the President an opportunity to talk about the importance of making this information available so that children in America will no longer threatened by the few "bad apple" child care workers. NOTE: THE FOLLOWING INITIATIVE WILL PROBABLY BE ANNOUNCED AT A SEPARATE EVENT FOLLOWING THE CONFERENCE. Health Outreach in Child Care Centers. The President would announce a plan to enroll eligible children in child care centers in Medicaid or the new state children's health program. This would build on the Administration's commitment to linking health care and child care through the Healthy Child Care America Campaign, which promotes safety and healthy development in child care and improves access to immunization, nutrition and other health services in child care settings. We are working with Chris Jennings and Jeanne Lambrew on a series of proposals, including: Clarifying regulations to ensure that child care centers and schools distribute information about these health programs, assist in filling out applications, and grant presumptive eligibility for Medicaid. Requiring states in their state plans for the children's health program to describe how they will use child care centers to enroll children. Developing an agreement with child care providers, school nurses and teachers to work together on education and outreach to families. This would include release of a Medicaid handbook for child care workers (currently being produced at HHS) and a simple brochure describing the new children's health program. Chris and Jeanne will discuss any health care proposals with the National Governors Association staff to ensure that states will support our policy. 2 Nicole R. Rabner 10/15/97 11:59:03 AM Record Type: Record To: Elena Kagan/OPD/EOP CC: Jennifer L. Klein/OPD/EOP Subject: policy announcements at the WH Conf. Following up on our meeting yesterday about policy announcements for the Child Care Conference, Jen and I want to run an idea by you. As you know, the two announcements that we discussed address 1) quality (through focusing on the provider -- scholarships/loan forgiveness and background checks), and 2) affordability (through creating a Treasury working group of business executives). This means that we are making a policy "downpayment" in two of the three areas we want ultimately to address in the SOTU/budget submission, leaving out after-school care. We have two options -- one is to keep the announcemnents as they are now, and talk about after-school care in the President's remarks. The other is to make an announcement that addresses the need for after-school care, thereby having an announcement in each of the three areas. Here is the proposal: As you may know, we have been working with the Corporation for National Service to explore the nexus between service and child care, specifically with after-school care. As it turns out, CNS estimates that approximately two-thirds of its national service programs work to address the needs of children and youth, often in child care and after-school settings. Thousands of AmeriCorps members, Learn and Serve America participants, and Senior Corps participants are working alongside child care providers, educators and community-based professionals, helping to expland and enhance child care and out-of-school time programming. CNS has developed, but apparently never formally launched, a new partnership called the To Learn and Grow (TLG) initiative to coordinate a network of public and private organizations committed to expanding access to and improving quality of before and after-school programs by integrating service and service-learning (it was developed as a result of a Forum on Explanding Opportunities in Out-of-School Time held last year). The partners include CNS, HHS, DOE, National Association of Child Care Resource and Referral Agencies, the School Age Care Project at Wellesley (the founder and director of which is on the first panel of the Conference), Save the Children, the YMCA, and others. TLG builds on CNS's exisiting programs by: --Incorporating national service participants and community volunteers into child care programs to provide additional hand to support the delivery of care. --Engaging children and youth in service-learning programs as one of the variety of enrichment activities within out-of-school time programs. The President could formally launch this new effort and/or release a new "How-To Manual on Integration of Service & School-Age Care," which is a joint publication between CNS and the Wellesley School Age Care Project that examines the quality of school time programming, the integration of service and school-aged care, national service resources, effective national service programs, and service-learning activities for children and youth. It can be ready for our purpose, and we have draft for you to review, if you'd like. We know you have a strong predisposition for not releasing reports (with which we generally agree), but you may change your mind when you see this one, as it provides a compelling overview of why school-age care opportunities are important, what the research shows about their positive effects on children in the short and long terms, and how communities can join service and school-age efforts. Let us know what you think and if you'd like to discuss further. THE WHITE HOUSE WASHINGTON October 20, 1997 MEMORANDUM FOR THE PRESIDENT FROM: BRUCE REED MELANNE VERVEER CC: THE FIRST LADY RE: WHITE HOUSE CONFERENCE ON CHILD CARE On October 23, you and the First Lady will host the White House Conference on Child Care in the East Room. This memorandum outlines the purpose and structure of the conference, the policy initiatives that we recommend you announce at the conference, and the process and direction of our work on a larger child care proposal to unveil this winter. Purpose and Structure of the Conference The White House Conference on Child Care has two purposes. First, it will call national attention to an issue that political leaders and policy makers historically have ignored, notwithstanding its enormous importance to working families. Second, it will provide a basis from which to launch a significant child care proposal in the State of the Union. The conference will address three critical child care challenges -- availability, affordability, and safety and quality. Many parents choose to stay at home and care for their children themselves. Yet millions of Americans, by choice or necessity, rely on child care and after-school programs to care for their children for part of each day. The conference will explore how the public and private sectors can respond to the need that Americans struggling to be both good parents and good workers have for safe, affordable child care. Morning Session. The morning session will begin with remarks by you and the First Lady and will include a video of children, parents, caregivers and others talking about child care. We believe your remarks should address the importance of child care for America's working families, note past Administration accomplishments on this issue, and announce several new policy initiatives as well as a commitment to unveil a broader child care agenda this winter. 1 You and the First Lady will then moderate a panel with two parts. The first three panelists will discuss why child care matters -- both to our children's development and to the nation's economy. The second four panelists will examine how well we are doing in meeting the challenge of assuring that good child care is available to working families. The first three panelists are: Ellen Galinsky, President, Families and Work Institute, who will discuss the relationship between quality child care and children's healthy development, particularly in the earliest years of life; Michelle Seligson, Founder and Director, National Institute on Out-Of-School Time, Wellesley College Center for Research on Women, who will discuss the importance of good after-school programs for youth; Secretary Rubin, who will discuss the need to address child care given dramatic changes in the workforce and economy. The second four panelists are: Secretary Shalala, who will discuss the strengths and weaknesses of child care across the country; Governor James Hunt of North Carolina, who will discuss how states are doing in meeting the challenge of assuring that working families have access to safe, affordable child care; Dr. Valora Washington, Program Director, W.K. Kellogg Foundation, who will discuss community efforts to meet this challenge; Patty Siegel, Executive Director, California Resource and Referral, who will share the experiences of parents. Afternoon Session. The afternoon session will begin with remarks by the Vice President and Secretary Riley. The afternoon panel will consider the roles that states, business and labor leaders, the faith community, health care professionals, and others can play in addressing this challenge. The panelists include: Major General John G. Meyer, Jr., Chief of Public Affairs United States Army; Dr. Susan Aronson, Member, American Academy of Pediatrics; Jane Maroney, State Legislator, Delaware; Bishop Joseph Sullivan, Vicar of Human Services, Brooklyn, New York; and Doug Price, President, FirstBank of Colorado. Agency and Satellite Sites. An additional 300 people will view the conference at three Federal agencies, and Secretaries Shalala, Riley, Glickman and Herman will host working sessions at these agency sites during the luncheon at the White House. In addition, the entire conference will be transmitted to satellite sites in at least 48 states. The Administration's regional administrators have helped to organize these satellite conferences, and Cabinet Affairs 2 has encouraged subcabinet officials to participate in them. Policy Announcements to be Made at the Conference We recommend that you indicate at the conference that you will propose a child care initiative in your State of the Union address and your fiscal year 1999 budget. We also recommend that you announce three policy proposals at the conference. 1. Child Care Working Group. You can name Secretary Rubin and Sanford Weill, Chief Executive Officer of The Travelers Group, as co-chairs of a working group on child care primarily made up of business leaders, with representation from labor and other community leaders. Sandy Weill has worked extensively on child care issues at several major corporations and as a member of then-Mayor Dinkins' Task Force on Child Care. The Child Care Working Group would report to you within 45 days on efforts that business leaders should undertake to help working families overcome the challenge of managing child care and work responsibilities. 2. Scholarships for Child Care Workers and Background Checks on Child Care Workers. Experts link the quality of child care to the quality of the caregiver. Yet child care providers often receive little training, and occasionally have unsuitable backgrounds for the profession. You can announce steps to support caregivers by ensuring that they are able to afford adequate training. At the same time, you can urge Congress to pass and states to ratify the "National Crime Prevention and Privacy Compact" to protect children from child care workers who have committed crimes. Scholarships. To help child care workers afford training, you can instruct the Department of Education to develop an outreach plan to inform students and institutions of the potential availability of Pell Grants. You also can announce a new scholarship program for child care workers. Even with Pell and other education programs that you have put in place, many child care workers cannot afford training. The new program would provide assistance to full- or part- time students working toward a Child Development Associate Credential or other degree in child development who agree to remain in the child care field for at least one year. Background Checks. You can also announce steps to make background checks on child care workers more effective. Today, many states prohibit the release of criminal history records for purposes other than ongoing criminal investigations. The Department of Justice is prepared to transmit to Congress on October 23 the "National Crime Prevention and Privacy Compact." The compact, which must be passed by Congress and ratified by the states, will enable states to share criminal history information for limited other purposes, including background checks on child care workers. 3 3. Service and School-Age Care. You can launch the "To Learn and Grow Partnership," a partnership of public and private organizations that will work together to expand access to and improve the quality of after-school programs through service activities. The partnership will encourage national service participants and community volunteers to teach in child care programs, and will engage children in service as part of after-school programs. You also can release the "How-To Manual," describing how to integrate service and school-age care, identifying opportunities for children to learn through service, and highlighting programs that are currently using service to enrich out-of-school time. Child Care Initiative To Be Announced After the Conference For the past several months, the Domestic Policy Council and the First Lady's Office have been leading a policy process on child care. The National Economic Council, the Office of Management and Budget, and the Departments of Health and Human Services, Treasury, Education, Labor, Defense, Justice, and Agriculture have participated. We have identified three key areas: affordability; availability; and safety and quality. In the weeks after the conference, we will prepare a memorandum for you outlining policy options in these areas. We are also exploring ways to support parents who want to stay at home to care for their children. Affordability. Increasing numbers of working families cannot afford decent child care, which can cost at least $4,000 a year for one child, and even more for infants and toddlers. While the average family pays about 7 percent of its income for child care, low-income families spend about a quarter of their income. The Federal government spent $2.9 billion in direct child care subsidies in fiscal year 1997 through the Child Care and Development Block Grant (CCDBG), which provides payments for about one million children. HHS estimates, however, that we are currently providing child care subsidies to less than a quarter of the families eligible for them. In addition, the Dependent Care Tax Credit provides more than $2 billion annually in tax relief for child care expenses. We are analyzing whether to expand either of these mechanisms. Availability. Access to child care is a problem for low-income and middle-income families alike. We are looking at two areas of particular concern -- helping businesses expand on-site care for their employees, and helping states and communities increase their supply of school-age care. We are exploring whether to provide tax credits for businesses that build and operate child care centers for their employees (the Rubin-Weill working group may make additional suggestions). We also are looking at a variety of ways -- including simplifying Federal requirements and funding streams -- to help states and communities create an adequate 4 supply of after-school programs. Safety and Quality. The quality of child care in this country is too often mediocre or poor. A recent four state study of child care centers found that one in eight centers expose children to unsafe or unsanitary conditions. Infants and toddlers are at the greatest risk, with 40 percent in care that poses a threat to their health and well-being. Only 14 percent of centers provide high quality care -- care that actually enhances growth and development. A study of child care in family-based settings found equally disturbing patterns. Over one-third of programs are rated inadequate, meaning that quality is low enough to harm children's development, and only 9 percent offer high-quality care. States are currently required to spend 4% of the funds they receive through the CCDBG on quality improvement. We are looking at ways to help states improve quality by providing additional funding to states that agree, for example, to improve and enforce health and safety standards, invest in training for caregivers, or create networks to support family day care providers. We are also developing a consumer information campaign to arm parents with the information they need to chose high quality care for their children. 5 THE WHITE HOUSE WASHINGTON October 20, 1997 MEMORANDUM FOR THE PRESIDENT FROM: BRUCE REED MELANNE VERVEER CC: THE FIRST LADY RE: WHITE HOUSE CONFERENCE ON CHILD CARE On October 23, you and the First Lady will host the White House Conference on Child Care in the East Room. This memorandum outlines the purpose and structure of the conference, the policy initiatives that we recommend you announce at the conference, and the process and direction of our work on a larger child care proposal to unveil this winter. Purpose and Structure of the Conference The White House Conference on Child Care has two purposes. First, it will call national attention to an issue that political leaders and policy makers historically have ignored, notwithstanding its enormous importance to working families. Second, it will provide a basis from which to launch a significant child care proposal in the State of the Union. The conference will address three critical child care challenges -- availability, affordability, and safety and quality. Many parents choose to stay at home and care for their children themselves. Yet millions of Americans, by choice or necessity, rely on child care and after-school programs to care for their children for part of each day. The conference will explore how the public and private sectors can respond to the need that Americans struggling to be both good parents and good workers have for safe, affordable child care. Morning Session. The morning session will begin with remarks by you and the First Lady and will include a video of children, parents, caregivers and others talking about child care. We believe your remarks should address the importance of child care for America's working families, note past Administration accomplishments on this issue, and announce several new policy initiatives as well as a commitment to unveil a broader child care agenda this winter. 1 You and the First Lady will then moderate a panel with two parts. The first three panelists will discuss why child care matters -- both to our children's development and to the nation's economy. The second four panelists will examine how well we are doing in meeting the challenge of assuring that good child care is available to working families. The first three panelists are: Ellen Galinsky, President, Families and Work Institute, who will discuss the relationship between quality child care and children's healthy development, particularly in the earliest years of life; Michelle Seligson, Founder and Director, National Institute on Out-Of-School Time, Wellesley College Center for Research on Women, who will discuss the importance of good after-school programs for youth; Secretary Rubin, who will discuss the need to address child care given dramatic changes in the workforce and economy. The second four panelists are: Secretary Shalala, who will discuss the strengths and weaknesses of child care across the country; Governor James Hunt of North Carolina, who will discuss how states are doing in meeting the challenge of assuring that working families have access to safe, affordable child care; Dr. Valora Washington, Program Director, W.K. Kellogg Foundation, who will discuss community efforts to meet this challenge; Patty Siegel, Executive Director, California Resource and Referral, who will share the experiences of parents. Afternoon Session. The afternoon session will begin with remarks by the Vice President and Secretary Riley. The afternoon panel will consider the roles that states, business and labor leaders, the faith community, health care professionals, and others can play in addressing this challenge. The panelists include: Major General John G. Meyer, Jr., Chief of Public Affairs United States Army; Dr. Susan Aronson, Member, American Academy of Pediatrics; Jane Maroney, State Legislator, Delaware; Bishop Joseph Sullivan, Vicar of Human Services, Brooklyn, New York; and Doug Price, President, FirstBank of Colorado. Agency and Satellite Sites. An additional 300 people will view the conference at three Federal agencies, and Secretaries Shalala, Riley, Glickman and Herman will host working sessions at these agency sites during the luncheon at the White House. In addition, the entire conference will be transmitted to satellite sites in at least 48 states. The Administration's regional administrators have helped to organize these satellite conferences, and Cabinet Affairs 2 has encouraged subcabinet officials to participate in them. Policy Announcements to be Made at the Conference We recommend that you indicate at the conference that you will propose a child care initiative in your State of the Union address and your fiscal year 1999 budget. We also recommend that you announce three policy proposals at the conference. 1. Child Care Working Group. You can name Secretary Rubin and Sanford Weill, Chief Executive Officer of The Travelers Group, as co-chairs of a working group on child care primarily made up of business leaders, with representation from labor and other community leaders. Sandy Weill has worked extensively on child care issues at several major corporations and as a member of then-Mayor Dinkins' Task Force on Child Care. The Child Care Working Group would report to you within 45 days on efforts that business leaders should undertake to help working families overcome the challenge of managing child care and work responsibilities. 2. Scholarships for Child Care Workers and Background Checks on Child Care Workers. Experts link the quality of child care to the quality of the caregiver. Yet child care providers often receive little training, and occasionally have unsuitable backgrounds for the profession. You can announce steps to support caregivers by ensuring that they are able to afford adequate training. At the same time, you can urge Congress to pass and states to ratify the "National Crime Prevention and Privacy Compact" to protect children from child care workers who have committed crimes. Scholarships. To help child care workers afford training, you can instruct the Department of Education to develop an outreach plan to inform students and institutions of the potential availability of Pell Grants. You also can announce a new scholarship program for child care workers. Even with Pell and other education programs that you have put in place, many child care workers cannot afford training. The new program would provide assistance to full- or part- time students working toward a Child Development Associate Credential or other degree in child development who agree to remain in the child care field for at least one year. Background Checks. You can also announce steps to make background checks on child care workers more effective. Today, many states prohibit the release of criminal history records for purposes other than ongoing criminal investigations. The Department of Justice is prepared to transmit to Congress on October 23 the "National Crime Prevention and Privacy Compact." The compact, which must be passed by Congress and ratified by the states, will enable states to share criminal history information for limited other purposes, including background checks on child care workers. 3 3. Service and School-Age Care. You can launch the "To Learn and Grow Partnership," a partnership of public and private organizations that will work together to expand access to and improve the quality of after-school programs through service activities. The partnership will encourage national service participants and community volunteers to teach in child care programs, and will engage children in service as part of after-school programs. You also can release the "How-To Manual," describing how to integrate service and school-age care, identifying opportunities for children to learn through service, and highlighting programs that are currently using service to enrich out-of-school time. Child Care Initiative To Be Announced After the Conference For the past several months, the Domestic Policy Council and the First Lady's Office have been leading a policy process on child care. The National Economic Council, the Office of Management and Budget, and the Departments of Health and Human Services, Treasury, Education, Labor, Defense, Justice, and Agriculture have participated. We have identified three key areas: affordability; availability; and safety and quality. In the weeks after the conference, we will prepare a memorandum for you outlining policy options in these areas. We are also exploring ways to support parents who want to stay at home to care for their children. Affordability. Increasing numbers of working families cannot afford decent child care, which can cost at least $4,000 a year for one child, and even more for infants and toddlers. While the average family pays about 7 percent of its income for child care, low-income families spend about a quarter of their income. The Federal government spent $2.9 billion in direct child care subsidies in fiscal year 1997 through the Child Care and Development Block Grant (CCDBG), which provides payments for about one million children. HHS estimates, however, that we are currently providing child care subsidies to less than a quarter of the families eligible for them. In addition, the Dependent Care Tax Credit provides more than $2 billion annually in tax relief for child care expenses. We are analyzing whether to expand either of these mechanisms. Availability. Access to child care is a problem for low-income and middle-income families alike. We are looking at two areas of particular concern -- helping businesses expand on-site care for their employees, and helping states and communities increase their supply of school-age care. We are exploring whether to provide tax credits for businesses that build and operate child care centers for their employees (the Rubin-Weill working group may make additional suggestions). We also are looking at a variety of ways -- including simplifying Federal requirements and funding streams -- to help states and communities create an adequate 4 supply of after-school programs. Safety and Quality. The quality of child care in this country is too often mediocre or poor. A recent four state study of child care centers found that one in eight centers expose children to unsafe or unsanitary conditions. Infants and toddlers are at the greatest risk, with 40 percent in care that poses a threat to their health and well-being. Only 14 percent of centers provide high quality care -- care that actually enhances growth and development. A study of child care in family-based settings found equally disturbing patterns. Over one-third of programs are rated inadequate, meaning that quality is low enough to harm children's development, and only 9 percent offer high-quality care. States are currently required to spend 4% of the funds they receive through the CCDBG on quality improvement. We are looking at ways to help states improve quality by providing additional funding to states that agree, for example, to improve and enforce health and safety standards, invest in training for caregivers, or create networks to support family day care providers. We are also developing a consumer information campaign to arm parents with the information they need to chose high quality care for their children. 5 Nicole R. Rabner 10/15/97 11:59:03 AM Record Type: Record To: Elena Kagan/OPD/EOP CC: Jennifer L. Klein/OPD/EOP Subject: policy announcements at the WH Conf. Following up on our meeting yesterday about policy announcements for the Child Care Conference, Jen and I want to run an idea by you. As you know, the two announcements that we discussed address 1) quality (through focusing on the provider scholarships/loan forgiveness and background checks), and 2) affordability (through creating a Treasury working group of business executives). This means that we are making a policy "downpayment" in two of the three areas we want ultimately to address in the SOTU/budget submission, leaving out after-school care. We have two options -- one is to keep the announcemnents as they are now, and talk about after-school care in the President's remarks. The other is to make an announcement that addresses the need for after-school care, thereby having an announcement in each of the three areas. Here is the proposal: As you may know, we have been working with the Corporation for National Service to explore the nexus between service and child care, specifically with after-school care. As it turns out, CNS estimates that approximately two-thirds of its national service programs work to address the needs of children and youth, often in child care and after-school settings. Thousands of AmeriCorps members, Learn and Serve America participants, and Senior Corps participants are working alongside child care providers, educators and community-based professionals, helping to expland and enhance child care and out-of-school time programming. CNS has developed, but apparently never formally launched, a new partnership called the To Learn and Grow (TLG) initiative to coordinate a network of public and private organizations committed to expanding access to and improving quality of before and after-school programs by integrating service and service-learning (it was developed as a result of a Forum on Explanding Opportunities in Out-of-School Time held last year). The partners include CNS, HHS, DOE, National Association of Child Care Resource and Referral Agencies, the School Age Care Project at Wellesley (the founder and director of which is on the first panel of the Conference), Save the Children, the YMCA, and others. TLG builds on CNS's exisiting programs by: --Incorporating national service participants and community volunteers into child care programs to provide additional hand to support the delivery of care. --Engaging children and youth in service-learning programs as one of the variety of enrichment activities within out-of-school time programs. The President could formally launch this new effort and/or release a new "How-To Manual on Integration of Service & School-Age Care," which is a joint publication between CNS and the Wellesley School Age Care Project that examines the quality of school time programming, the integration of service and school-aged care, national service resources, effective national service programs, and service-learning activities for children and youth. It can be ready for our purpose, and we have draft for you to review, if you'd like. We know you have a strong predisposition for not releasing reports (with which we generally agree), but you may change your mind when you see this one, as it provides a compelling overview of why school-age care opportunities are important, what the research shows about their positive effects on children in the short and long terms, and how communities can join service and school-age efforts. Let us know what you think and if you'd like to discuss further. 09/30/97 TUE 15:58 FAX 2025652781 CNS 002 September 30, 1997 MEMORANDUM FOR JEN KLEIN NICOLE RABNER JOAN LOMBARDI FROM: SUSAN STROUD JULIE DEMEO CC: LOUIS CALDERA JOHN GOMPERTS TOM ENDRES GARY KOWALCZYK SUBJECT: POSSIBLE CNS ANNOUNCEMENTS FOR THE WHITE HOUSE CONFERENCE ON CHILD CARE In preparation for the White House Conference on Child Care, October 23rd, we have identified possible national service announcements that could be made and identified model national service programs that could be highlighted at the conference as successful examples of enhancing child care through service. BACKGROUND: CNS PRIORITIES The Corporation for National Service (CNS) has focused on addressing the needs of children and youth in the following priority areas: education, human needs, public safety, and the environment. We estimate that approximately two-thirds of our national service programs work to address the needs of children and youth, often in child care and after school care settings. This year, CNS added a special emphasis for America Reads programming. Any new money received in our FY 1998 budget will be targeted for America Reads activities, in both school-based and community-based settings. Last year, the Corporation launched the To Learn & Grow out of school time care initiative. To Learn & Grow is a public-private partnership dedicated to expanding access to and enhancing the quality of out of school time care by integrating service and service-learning. National partners include the Corporation for National Service, the Department of Health & Human Services, the Department of Education, The National Association of Child Care Resource and Referral Agencies, the School Age Child Care project at Wellesley College, Save the Children, the YMCA of the USA, and others. 09/30/97 TUE 15:59 FAX 2025652781 CNS 003 THE ROLE OF SERVICE IN CHILD CARE Around the country, parents, teachers, community members, and students are engaging in service to meet the needs of children and youth in child care and after school care settings. Thousands of AmeriCorps members, Learn and Serve America participants, and Senior Corps participants are working alongside child care providers, educators and community-based professionals. National service programs have developed effective and replicable models for using service as a strategy to expand and enhance child care and after school programs. More specifically, national service is helping expand and enhance child care and out-of school time programming by using national service participants to provide one or more of the following activities in child care or after school care programs where they serve: Health resources/social service resources (screenings, immunization information, nutrition/health education etc making the child care or after school care setting more of a single point of contact for the child) America Reads /literacy tutoring educational component Service-learning opportunities (engaging the children in child care programs in community service) See attached descriptions of national service programs. CNS DELIVERABLES Below are several options for CNS involvement in the White House Conference on Child Care. This conference offers the Administration an opportunity to highlight the positive effects of integrating service and child care and to showcase what we are doing well in national service programs across the country. I. Announcements A. Launch the To Learn & Grow Initiative CNS has organized the To Learn and Grow (TLG) partnership initiative to coordinate a network of public and private organizations committed to expanding access and improving quality of before and after school programs. TLG developed as a result of a Forum on Expanding Opportunities in Out-of-School Time held last year. It was not named To Learn & Grow until April and still has never been formally launched. See attached description of TLG. B. Release the "How-To Manual on Integration of Service & School-Age Care" This joint publication between the Corporation for National Service and the Wellesley School-Age Child Care Project should be ready for release by mid- Oct.8 October. It examines quality out of school time programming, the integration of service and school-aged care, national service resources, effective national service potus programs, and service-learning activities for children and youth. Event 09/30/97 TUE 15:59 FAX 2025652781 CNS 004 II. Highlight Model National Service Programs Attached is a list of national service programs already providing child care and after school care or engaged in enhancing existing child care and after school care programs. We could select models and best practices to highlight what we are already doing from our existing "Child Care Corps." Below are examples of five ways service and child care/after school care can be integrated. There are several exemplary national service programs across the nation that represent each of these types. A. Child Care Corps-type model: ACT [Action for Children Today] This AmeriCorps national program is administered by the National Association of Child Care Resource & Referral Agencies. The program uses AmeriCorps members to provide technical assistance and coordination of services for child ) care providers in several states. B. Mentoring/Child Care or After School Care model: Foster Grandparent Programs (nationwide) Foster Grandparrents have been enhancing quality care for years by serving as mentors in child care and after school programs. Currently over 4,000 Foster Grandparents serve in 1,400 day care sites and 6,800 RSVP's serve in 1,600 sites. C. America Reads/Child Care model JUMPSTART (Massachusetts, Connecticut) Jumpstart places college students, who are part-time AmeriCorps members, in daycare centers to teach a literacy-based pre-school curriculum to low-income children. Approximately 50% of the Corps members are also Federal Work Study students and can earn work study wages for their service with Jumpstart. Through Jumpstart, the college students are trained and by the end of their service are eligible to receive their certification to teach pre-school. D. Health Service Outreach/After School Care model Sheridan Family Resource Center (Colorado) AmeriCorps Members tutor and mentor 250 at-risk youth attending Sheridan Elementary School and implement interactive after-school and summer camp programs for more than 400 students. Additionally, Members conduct outreach and education to more than 250 youths and senior citizens on accessing health services offered by the Sheridan School-Based and Community Clinics. 32 AmeriCorps Members serve in this program. 005 09/30/97 TUE 15:59 FAX 2025652781 CNS E. Service-Learning/After School Care model United Youth Corps of Maryland - MCC & Civic Works AmeriCorps Members maintain and restore 15 state forests, parks, and wildlife management areas. Members rehabilitate abandoned houses, construct 10 community parks and gardens in low-income Baltimore neighborhoods, and tutor 1,000 students with special needs. In addition, Members develop an after-school program where 160 middle school students perform community service and participate in environmental education activities. III. Challenge from the President or First Lady A. Challenge all child care and after school care programs to integrate service This could be done by any of the following: adding an America Reads or educational tutoring component to their program adding a mentoring component to their program organizing service-learning activites for the children in the program partnering with national service participants or community professionals to link children to other health and social services in the community NOTE: Attached are national service program examples (AmeriCorps, Senior Corps, and Learn & Serve America) in child care & after school care settings. Manual- - more voluntecrs in these settings / 00 's hrs - help org. young people in service activities -boys act, I a entimof serice 006 09/30/97 TUE 16:00 FAX 2025652781 CNS To Learn and Grow A National Initiative for Service and Out-of-School Time Corporation for National Service U.S. Department of Education Child Care Bureau. Administration on Children and Families, U.S. Department of Health and Human Services National Association of Child Care Resource and Referral Agencies National School-Age Care Alliance Save the Children National Institute on Out-of-School Time at Wellesley College Center for Research on Women YMCA of the USA Recognizing that children spend more than 4,000 of their waking hours outside the;classroom each year and that working parents need additional resources to insure the safety and school success of their children, the Corporation for National Service has organized the To Learn and Grow (TLG) partnership initiative. TLG coordinates a network of public and private organizations committed to expanding access and improving quality of programs serving children and youth during non-school hours. National TLG partners include the Corporation for National Service, U.S. Department of Education, U.S. Department of Health and Human Services Child Care Bureau, National Association of Child Care Resource and Referral Agencies, National Institute on Out-of-School Time at Wellesley College, National School-Age Cate Alliance, Save the Children and the YMCA of the USA. The TLG initiative supports a vision for out-of-school time in which families, schools and communities working together help create safe places, tutor and mentor children, and offer youth positive alternatives to gangs and drugs. Central to the TLG mission is the idea that out-of-school time programs should be an integral part of the community and should help develop the community by reducing crime, connecting people. beautifying neighborhoods, and fostering a new generation of responsible citizens and civic leaders. The TLG initiative promotes service and service-learning activities as a tool to help expand and enrich out- of-school time activities for children and youth by: Incorporating national service participants and community volunteers into child care programs to provide additional hands to support the delivery of care. Activities include AmeriCorps members serving full-time as volunteer trainers and coordinators; Learn and Serve America students earning school credit while tutoring children part-time; parents and other community volunteers organizing young people in service activities; and Senior Corps volunteers sharing their lifetime of experience in youth mentoring roles. Engaging children and youth in service-learning projects as one of the variety of enrichment activities within quality out-of-school time programs. Activities include neighborhood clean- ups, public health awareness campaigns, tutoring programs for younger children, and special care for the homebound elderly. Service-learning projects and curricula help children and youth learn responsibility, acquire leadership skills, and improve their self-estcem by playing these vital roles in their communities. Through publications, conferences, training and technical assistance, the TLG initiative supports a number of collaborative projects to help further its goals. Currently, three pilot teams have been identified to develop strategies for TLG partnerships at the state level in Massachusetts, Illinois and Washington. Scheduled for publication in early Fall 1997. the Wellesley National Institute on Out-of-School Time (NIOST) is drafting a how-to manual on service and out-of-school time which will highlight effective practices. Most recently, the TLG partnership put forward a commitment at the President's Summit for America's Future to enlist 10,000 college and high school students in service in school-age care programs and engage 200,000 children and youth in service-learning activities in the non-school hours. For more information on the To Learn and Grow initiative, please contact the Corporation for National Service at (202) 606-5000, Ext 484, e-mail: [email protected]. 10/12/97 FRI 17:40 FAX 003 NATIONAL SERVICE AND CHILD CARE Why National Service and Child Care There is a clear and pressing need. GAO estimates that in the year 2002, the supply of child care services would meet as little as 25 percent of the demand in some urban areas. National service and volunteers can bring new people who are highly motivated and well trained to meet the child care needs of communities across the country. America's youth have a vast and still untapped potential for service, and they respond when asked. According to the Independent Sector, 59 percent of young people ages 12 to 17, and 38 percent of 18- to 24-year-olds say that they did some service last year. We must find persuasive ways to ask young people to apply their energy, enthusiasm, and new ideas to help solve one of our nation's pressing problems. National service offers a proven model. Around the country, parents, teachers, community members, seniors and older students are engaging in service to meet the needs of younger children in child care and after school care settings. Thousands of AmeriCorps members, college and high school students, and seniors already are working alongside child care providers, educators, and community-based professionals. Indeed, two-thirds of the national service programs supported by the Corporation for National Service address the needs of children and youth, and many do so in child care and after-school settings. Our Nation's seniors are hungry for service opportunities, and intergenerational programs involving seniors and children are highly effective. Well elders comprise over 80 percent of our senior population, and studies show they are likely to serve when asked. National service makes this match. Quality out-of-school time is an opportunity for children and youth to develop positive and consistent relationships with adults, access a safe place, and participate in constructive activities. These activities occur in a wide variety of organizational settings and agencies, including schools, community-based organizations, YMCAs, Campfire Boysland Girls, Boys and Girls Clubs, churches, and cooperative extensions--organizations that know the value of service and volunteers and know how to make after-school programs work. Suggested Presidential Announcement "Providing quality child care is a goal to which we can all contribute, and our national service programs, including AmeriCorps, will play a major role in meeting that goal. Today I am announcing the release of a manual that shows out-of-school time programs how they can incorporate service to strengthen their efforts. By the end of this year, the Corporation for National Service will have training and technical assistance available to those who want to use national service and volunteers to help meet their needs. These resources will not only improve the delivery of quality care, but also engage our nation's youth in community service and service-learning activities--a commitment made at the Presidents' Summit in Philadelphia earlier this year." 10/17/97 FRI 17 : 40 FAX 0 004 PROGRAM EXAMPLES Jumpstart AmeriCorps Program uses AmeriCorps Members and Work Study students to provide school readiness activities to needy children and their families, including many children enrolled in Head Start programs. Members are paired with a preschool-age child, engaging the child and his or her family in school readiness activities, particularly around early childhood literacy. Members garner community interest and support through an annual "Children Across the City" day, where parents, their children, and other community members are introduced to a variety of learning activities for preschool age children. Through Jumpstart, the college students are trained and by the end of their service are eligible to receive their certification to teach pre-school. Jumpstart is in multiple locations, including Boston, New York, and Washington, DC. Columbia University's Community Impact program uses AmeriCorps members to carry out a wide range of direct service and capacity-building activities. The program provides educational enrichment and mentoring activities for low-income public school students and one-on-one tutoring for youth from K-3rd grade in collaboration with the YMCA, The project also supports a network of service learning programs in Empowerment Zone cities. The Retired and Senior Volunteer Program in St. Paul, Minnesota, pairs seniors and middle school students to deliver after-school programs to 900 children in kindergarten through third grade. The Sheridan Family Resources Center (Colorado) uses AmeriCorps members to tutor at-risk youth attending Sheridan Elementary School, as well as to implement after-school and summer camp programs for more than 400 students. Additionally, members conduct outreach and education to more than 250 youths and senior citizens on accessing health services offered by the Sheridan School-Based and Community Clinics. September 15, 1997 MEMORANDUM FOR HILLARY RODHAM CLINTON CC: BRUCE REED MELANNE VERVEER ELENA KAGAN FROM: JENNIFER KLEIN NICOLE RABNER RE: CHILD CARE As you know. over the past few months, we have been preparing for the upcoming White House Conference on Child Care on two tracks: policy development and conference planning. The purpose of this memorandum and binder is to give you an overview of our progress with the policy planning process and to solicit your advice and ideas. Also included in the binder is information for discussion on the conference format. We have divided the policy development discussions into three broad categories -- 1) quality, 2) affordability, and 3) school-age care -- and have led an interagency process of examining current child care policy in each of these areas and exploring ways to improve it. Our goal to date has been to identify the major policy challenges for possible focus, which this memo outlines. It is now time to begin to prioritize among the many options and make strategic decisions about where to recommend investing limited resources. Please note also that we do not anticipate announcing many of these options at the conference itself, as the event will take place ahead of the budget process. However, we do expect to have some important policy announcements ready for the conference, as well as a process in place to further develop others for later announcement (perhaps at the State of the Union). 1. Quality Issues relating to quality of care are perhaps the most challenging and important that we face. As you know, studies reveal a quality crisis in child care. For instance, one study of child care centers shows that 10% of children in center-based care are in care that is dangerous to their health and safety, 70% are in care that is barely adequate, and only 20% are in high quality care. Infants are at greatest risk, with 40% in care that is dangerous to their health and safety. 1 While there is clear agreement that high quality care for all children is our goal, there exist underlying concerns about pursuing policy that increases the quality of care. but prices care out of the reach of working parents, as well. For that reason, the discussion of quality and affordability go hand-in-hand. Our discussion of policy related to quality has several components: A. Health and safety standards B. Professional development and screening C. Quality enhancement A. HEALTH AND SAFETY STANDARDS National child care standards are extremely controversial. At the same time, experts, advocates and parents seem to agree that with the clear absence of state leadership in this area, there is a role for the federal government to play. The question with which we are grappling is the nature and extent of that role. Included in this binder is a memo prepared by the Department of Maternal and Child Health at HHS that outlines various policy options and examines the advantages and disadvantages of each. Perhaps the most promising policy option involves a set of national child care standards recently- released by HHS for states' voluntary use. The standards, called Stepping Stones (and included in the binder), is a reader-friendly document extrapolated from the 1992 National Health and Safety Performance Standards: Guidelines for Out-of-Home Care, which was developed by the American Public Health Association in cooperation with the American Academy of Pediatrics through a grant support by HHS. We could urge. for example, that states use Stepping Stones by offering them incentive grants if they agree to use these guidelines. In addition to the options outlined in the memo included in the binder, we are examining immediate steps we might be able to take, along the lines of the regulation recently promulgated that requires immunizations in federally-supported child care settings. B. PROFESSIONAL DEVELOPMENT AND SCREENING Professional Development Experts routinely link the quality of any child care setting to the quality of the child care providers themselves. Yet child care providers are among the lowest paid, least trained professionals, and the profession not surprisingly experiences a very high turn-over rate. We are exploring several policy options related to enhancing professional development, some of which 2 are explored in the binder: Creating a national child care provider scholarship fund which could be available to states conditioned on their setting standards for child care provider preparation and/or facilitating loan forgiveness or Pell Grant expansion to assist and encourage child care professionals to seek training; Linking compensation to training for child care providers by requiring that states set higher reimbursement rates for providers that meet higher training standards, to address high turn-over rates and encourage providers to seek higher education; and Establishing a National Child Care Provider Day to stimulate national recognition of the important work of child care providers and to urge talented people to join the profession. Screening of Child Care Providers Making sure that child care providers are properly screened for criminal/abuse histories is a compelling issue; it is also one that is wrought with complications of cost. jurisdiction and effectiveness. Today, there exists no national standard for criminal (state/FBI records) and/or civil (child abuse registry) background checks for child care providers. Background checks requirements are made at the state level, and today, while state laws routinely require these checks for people who work in banks, for example, no consistent requirement exists for child care providers. While a few federal laws have been passed to either facilitate or encourage such checks, they have had little impact and substantial obstacles remain: No national standards exist for background checks. "Background checks" can mean either a criminal history name check, a fingerprint check, or a civil records check. Moreover, states vary widely on who they check (part-time/full-time employees) and the scope of crimes they are checking; There is no single database for background checks. The feds and the states have their own information systems and many criminal justice records remain decentralized at the local level. In addition, these information systems may not collect all of the relevant information relevant for day care workers (e.g., sex offender registry may identify a convicted child molester but not a child abuser); and The cost of background checks can be substantial. Fingerprint checks are at least three times as expensive as name checks, but are more reliable. Concerns were raised about passing these costs along to the customers, many of whom may already find child care costs prohibitive. Moreover, child care facilities have a high rate of employee turn over. 3 Since the Supreme Court's decision the Brady Law, there is a heightened sensitivity to imposing mandates on states in this area, particularly without providing additional funding. Our discussion on moving forward was focused on an Interstate Compact bill which the Justice Department is preparing the send to the Hill this month. Under the Compact -- which must first be passed by Congress and then by individual states -- the FBI would maintain an index of all of the state-maintained criminal history records and the ground rules for states to share their information. The Compact would be a solid first step to expand the availability of criminal history records for "non-criminal justice purposes." The downside is that each state needs to ratify the compact if they want to participate-- which could take a long time. C. QUALITY ENHANCEMENT Included in the binder is a memo prepared by HHS that outlines policy options specific to the question of child care quality enhancement. A range of ideas are discussed, including: Creating a quality incentive fund that would be available to states for quality improvements in a number of areas, such as promoting accreditation. providing consumer education, providing professional training, meeting standards, etc.: Establishing a family child care network support fund that would be available to states to establish and support family child care networks. Family child care settings are particularly vulnerable to poor quality, because of their isolation from any support networks; and Creating a national public awareness campaign, stimulating technology and establishing a research fund designed to improve consumer awareness and care. 2. Affordability The federal government has two mechanisms for helping working parents afford child care -- the tax system. through the Dependent Care Tax Credit (DCTC) and the block-grant subsidy system, through the Child Care and Development Block Grant (CCDBG). We are exploring ways to expand and improve each to reach more working parents. Included in the binder are memos that examine the two systems and outline possible approaches to reform. We are waiting for HHS and the Department of Treasury to complete its analysis of how these two systems interact what income levels are being adequately covered and who is being left out -- before we devise specific recommendations in this area. To date, the most promising policy proposals are: Reforming DCTC to adjust the income slide parameters for eligibility and increasing the 4 amount of qualifying expenses (neither has not been adjusted for inflation since 1982); and Increasing subsidy dollars to states to reach more people. possibly conditioned on certain quality-related initiatives undertaken by the states. 3. School Age Care In our many focus groups with experts and advocates on child care, one message was very clear - - the need for after-school programs is extreme and the evidence has never been more clear that these programs are good investments, in terms of education enhancement, crime reduction and teen pregnancy prevention. The Department of Education is in the process of completing its proposal for an ambitious expansion of federal support for after-school programs. Included in this binder is a overview of current federal programs in this area and some of the compelling supporting evidence. 5 THE WHITE HOUSE GREAT work WASHINGTON BR October 20, 1997 MEMORANDUM FOR THE PRESIDENT Review asap FROM: BRUCE REED MELANNE VERVEER Gene CC: THE FIRST LADY RE: WHITE HOUSE CONFERENCE ON CHILD CARE On October 23, you and the First Lady will host the White House Conference on Child Care in the East Room. This memorandum outlines the purpose and structure of the conference, the policy initiatives that we recommend you announce at the conference, and the process and direction of our work on a larger child care proposal to unveil this winter. Purpose and Structure of the Conference The White House Conference on Child Care has two purposes. First, it will call national attention to an issue that political leaders and policy makers historically have ignored, notwithstanding its enormous importance to working families. Second and relatedly, it will provide a basis from which to launch a significant child care proposal in the State of the Union. The conference will address three critical child care challenges availability, affordability, and safety and quality. Many parents choose to stay at home and care for their children themselves. Yet millions of Americans, by choice or necessity, rely on child care and after-school programs to care for their children for part of each day. The conference will explore how the public and private sectors can respond to the need that Americans struggling to be both good parents and good workers have for safe, affordable child care. Morning Session. The morning session will begin with remarks by you and the First Lady and will include a video of children, parents, caregivers and others talking about child care. We believe your remarks should address the importance of child care for America's working families, note past Administration accomplishments on this issue, and announce several new policy initiatives as well as a commitment to unveil a broader child care agenda this winter. You and the First Lady will then moderate a panel with two parts. The first three panelists will discuss why child care matters - both to our children's development and to the nation's 1 economy. The second four panelists will examine how well we are doing in meeting the challenge of assuring that good child care is available to working families. The first three panelists are: Ellen Galinsky, President, Families and Work Institute, who will discuss the relationship between quality child care and children's healthy development, particularly in the earliest years of life; Michelle Seligson, Founder and Director, National Institute on Out-Of-School Time, Wellesley College Center for Research on Women, who will discuss the importance of good after-school programs for youth; Secretary Rubin, who will discuss the need to address child care given dramatic changes in the workforce and economy. The second four panelists are: Secretary Shalala, who will discuss the strengths and weaknesses of child care across the country; Governor James Hunt of North Carolina, who will discuss how states are doing in meeting the challenge of assuring that working families have access to safe, affordable child care; Dr. Valora Washington, Program Director, W.K. Kellogg Foundation, who will discuss community efforts to meet this challenge; Patty Siegel, Executive Director, California Resource and Referral, who will share the experiences of parents. Afternoon Session. The afternoon session will begin with remarks by the Vice President and Secretary Riley. The afternoon panel will consider the roles that states, business and labor leaders, the faith community, health care professionals, and others can play in addressing this challenge. The panelists include: Major General John G. Meyer, Jr., Chief of Public Affairs United States Army; Dr. Susan Aronson, Member, American Academy of Pediatrics; Jane Maroney, State Legislator, Delaware; Bishop Joseph Sullivan, Vicar of Human Services, Brooklyn, New York; and Doug Price, President, FirstBank of Colorado. Agency and Satellite Sites. An additional 300 people will view the conference at three Federal agencies, and Secretaries Shalala, Riley, Glickman and Herman will host working sessions at these agency sites during the luncheon at the White House. In addition, the entire conference will be transmitted to satellite sites in at least 48 states. The Administration's regional administrators have helped to organize these satellite conferences, and Cabinet Affairs has encouraged subcabinet officials to participate in them. 2 Policy Announcements to be Made at the Conference We recommend that you indicate at the conference that you will propose a child care initiative in your State of the Union address and your fiscal year 1999 budget. We also recommend that you announce three policy proposals at the conference. can name 1. Child Care Working Group. You could appoint Secretary Rubin and Sanford Weill, Chief A Executive Officer of The Travelers Group, as co-chairs of a working group on child care primarily made up of business leaders, with representation from labor and other community leaders. Sandy Weill has worked extensively on child care issues at several major corporations and as a member of then-Mayor Dinkins' Task Force on Child Care. The Child Care Working Group would report to you within 45 days on efforts that business leaders should undertake to help working families overcome the challenge of managing child care and work responsibilities. 2. Scholarships for Child Care Workers and Background Checks on Child Care Workers. ^ Experts link the quality of child care to the quality of the caregiver. Yet child care providers often receive little training, and occasionally have unsuitable backgrounds for the profession. You could can announce steps to support caregivers by ensuring that they are able to afford adequate can training. At the same time, you could urge Congress to pass and states to ratify the "National Crime Prevention and Privacy Compact" to protect children from child care workers who have committed crimes. Scholaships: To help child care workers afford training, you could can instruct the Department of Education to develop an outreach plan to inform students and institutions of the potential availability of Pell Grants. You also could can announce a new scholarship program for child care workers. Even with Pell and other education programs that you have put in place, many child care workers cannot afford training. The new program would partially fund the costs of formal education for full- or part-time students working toward a Child Development Associate Credential or bachelor degree in child development. Baskyround checks: You can also annance Second; you could take steps to make background checks on child care workers more effective. Today, many states prohibit the release of criminal history records for purposes other than ongoing criminal investigations. The Department of Justice is prepared to transmit to Congress on October 23 the "National Crime Prevention and Privacy Compact." The compact, which must be passed by Congress and ratified by the states, will enable states to share criminal history information for limited other purposes, including background checks on child care workers. Service and School- Age Care: 3. Launch of the "To Learn and Grow rtnership" and Release of the "How To Manual on ^ Integration of Service and School-Age Care." You could launch the "To Learn and Grow can 3 the Partnership," a partnership of public and private organizations that will work together to expand access to and improve quality of after-school programs through service activities. The partnership will encourage national service participants and community volunteers to teach in child care programs, and will engage children in service as part of after-school programs. You also could release the "How-To Manual," describing how to integrate service and school-age care, identifying opportunities for children to learn through service, and highlighting programs that are currently using service to enrich out-of-school time. Child Care Initiative To Be Announced After the Conference For the past several months, the Domestic Policy Council and the First Lady's Office have been leading a policy process on child care. The National Economic Council, the Office of Management and Budget, and the Departments of Health and Human Services, Treasury, Education, Labor, Defense, Justice, and Agriculture have participated. availability; and and We have identified three key areas: affordability; safety and quality; and availability of care for school age children. In the weeks after the conference, we will prepare a memorandum for you outlining policy options in these areas. We are also exploring ways to support parents who want to stay at home to care for their children. Affordability. Increasing numbers of working families cannot afford decent child care, which can cost at least $4,000 a year for one child, and even more for infants and toddlers. While the average family pays about 7 percent of its income for child care, low-income families spend about a quarter of their income. The Federal government spent $2.9 billion in direct child care subsidies in fiscal year 1997 through the Child Care and Development Block Grant (CCDBG), which provides payments for about one million children. HHS estimates, however, that we are currently providing child care subsidies to less than a quarter of the families eligible for them. In addition, the Dependent Care Tax Credit provides more than $2 billion annually in tax relief for child care expenses. We are analyzing whether to expand either of these mechanisms, as well as whether to provide tax credits for businesses that build and operate child care centers for their employees. Safety and Quality. The quality of child care in this country is too often mediocre or poor. A recent four state study of child care centers found that one in eight centers expose children to unsafe or unsanitary conditions. Infants and toddlers are at the greatest risk, with 40 percent in care that poses a threat to their health and well-being. Only 14 percent of centers provide high quality care care that actually enhances growth and development. A study of child care in family-based settings found equally disturbing patterns. Over one-third of programs are rated inadequate, meaning that quality is low enough to harm children's development, and Availability. Access to child care is 4 a problem for low. and moddle-incom families alike. We are looking at two areas of partieular m concern - helping businesses expand on-site care for their employees, and expendingh helping states + communities increase the supply of school-age care. We are reviewing exploring two ther the whether to provide tax credits for businesses that butb & opeate child care centers for their employees. the Rubin-Will nothing group may make additional suggestion suggestions.) INSERT A from P.S only 9 percent offer high-quality care. States are currently required to spend 4% of the funds they receive through the CCDBG on quality improvement. We are looking at ways to help states improve quality by providing additional funding to states that agree, for example, to improve and enforce health and safety standards, invest in training for caregivers, or create networks to support family day care providers. We are also developing a consumer information campaign to arm parents with the information they need to chose high quality care for their children. Availability of School Age Care. Finding child care is particularly difficult for parents of school age children. Five million children between the ages of five and 14 are left unsupervised every day, and studies show that children left alone are more likely to watch television and to use tobacco and alcohol. In addition, crime rates rise between 3 and 7 in the evening. Studies also show, however, that children in good after-school programs perform better in school, relate better to their peers, and are less likely to commit crimes and engage in other risky behavior. We are MOVE looking at a variety of ways -- including simplifying Federal requirements and funding streams -- TO A to help states and communities create an adequate supply of after-school programs. on P. 4 5 10/03/1397 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 02 MARTHA RADDATE 414- 3026 First Lady Hillary Rodham Clinton Remarks on Child Care University of Maryland, College Park October 3, 1997 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 03 Thank you very much. (applause) Thank you. Thank you very much. Thank you Neil, thank you Professor Seefeldt, thank you Congressman Hoyer, thank you, President Kirwan As I was sitting up here and Steny was introducing the President's family, when he introduced his wife, President Kirwan turned to me and said you know, I met her in Junior High School. He said, she sat behind me and she couldn't stand me and I thought, that's exactly the kind of memories I have from Junior High School, you know, the boy you really liked at the end of the year was the one you couldn't stand at the beginning of the year but this Junior High romance has certiunly stood the test of time and I'm delighted to be here with your family and with the family of his great University. I came here today for a number of reasons. Part of it as the President suggested, is because I enjoyed my visit to be the Commencement Speaker so much and was very honored to receive an Honorary Degree and also because I have followed with great interest the work that is being done at this University in many areas but in particular, I have been impressed by the work that has been done in the area of human development, social and public policy, and we of course, as you know, we're blessed in the White House by having Professor Galston with us for a number of years so I feel a real kinship with the work that is done here and the people who are part of this great University community. So when the opportunity arose for me to come and speak with you about an upcoming White House Conference on Child Care, I immediately seized it. Because as the Congressman said, the President and I are hosting a White House Conference on Child Care on October 23rd and I wanted to come and tell you why this is an issue that deserves White House attention, deserves the attention of our Nation, one that we hope will raise awareness of these issues around our country. Some of you may recall that last spring the President and I hosted a Conference on Early Learning and Brain Research and we brought to the 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 04 Nation's attention the very exciting work that has been done by researchers here at N.H and elsewhere across the country that demonstrates clearly how important it is that we take the first three years of life because of what is happening in a child's brain and we wanted to get that information out because although many people intuitively knew that and experts like Professor Seefeldt taught that, there wasn't the hard data that supported that information until recently with the kind of work that has been going on in brain research and so for a lot of reasons, this is a time when all of us have to focus on what we best can do in our own homes and families is well as in our larger society to insure that each child has a chance to live up to his or her promise. I saw that in action this morning here at the Center for Young Children, what a wonderful facility you have here, a Child Care Center that is warm and inviting with workers that are creative and energetic and focus, a range of books and toys and crafts materials. I answered questions from the five year olds who wanted to know, among other things, what my favorite food was, what my favorite color was, and then a real stumper, what my favorite roller coaster was. I had to confess to this little boy that it has been so long since I've been on a roller coaster, I couldn't remember the names of any of the roller coasters I like but I certainly had the feeling that this is a place where children are treasured and valued and stimulated, a place that any of us would happily stay for juice and nap time any day. But, that Center is far too rare. Even though more and more families are seeking child care, in fact, over half of the infants under age one are in day care, twelve million children under the age of six, and seventeen million more, age six through thirteen, have both parents or their only parent in the work force. The plain fact is that there is simply not enough quality care for the children who need it. Quality child care is financially out of reach for the hard working American families whose children deserve the best attention they can receive. So today I come with a very straightforward proposition that this situation must 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 05 change for the sake of our children and our future. And there are ways I want to suggest that each of us can participate in this change. Every working parent in this room and in this country knows how urgent the matter is, any Mom or Dad who has ever left a child with a care giver for even a minute has felt at the gut level the importance of quality care. The stress around child care affects families ranging from the poorest all the way to the most affluent. It is a daily pressure for parents with preschoolers and parents with children in school who for whatever reason cannot get home to supervise a child themselves. For more than twenty five ears, I have worked on issues affecting children and families, but in the last four and a half years I've been privileged to travel around our country on my own and with my husband, listening and talking with parents about their economic concerns, the issues that affect them on the streets where they live, whether its crime or the environment, and I've heard over and over again how important child care is. Yet, despite its importance in our everyday lives, it is not an issue that wordbox been dealt with effectively by our society. Now, there are many reasons for this oversight and some of you who are students of human development and child care could recite many of thera, I'm sure. But, I think its fair to say that until the demographics of our citizenry changed until economic forces and women's choices led so many mothers into the work force, this was not an issue that many people thought was serious. It was, like many issues, affecting children in the past, viewed as a soft issue that was a disproportionate concern to women. Yet now we know it is one of the hardest issues we face and it is an issue that had economic and social implications that go far beyond the individual concern that each of us brings to it. Fortunately, times are changing. Partly because of the work that many of you are doing, partly because more and more: parents are speaking out, partly because America's employers have come to understand that the rength of their bottom lines depends on workers who are not absent, who will have their mind on their 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 06 work when they're there, whose child care needs are being met and partly because We have people in leadership like the President of this University, like this member of Congress before you who represents you, and because of my husband and members of Congress and State Legislators of both parties and many Governors who have made this a priority. All of this brings us together in the name of a shared belief, that the children of our country deserve child care as fine as that provided right here at this University. In fact, American children deserve the best care in the world. Now, there are many reasons to put our childrens needs first but let me just mention a few of them. One reason, as I've already stated is because we know that how we care for our children is critical to their intellectual and emotional development. You know, it wasn't so long ago and I can actually recall when I was younger and thinking about children a lot and even pregnant with my own, that it used to be kind of a joke among a lot of fathers I knew that they would say, well, you know let's wait until he can throw a ball or she can talk to me and then I'll pay attention and, you know, it was the kind of attitude that had been prevalent for most of history that you know, very young children should be cared for by their mothers, other women, that there wasn't much for fathers to do because there wasn't much happening until a child started to in some way assert a personality, act on his or own. Well, now we know clearly that that was mistaken. As we talked about at the White House Conference on Early Childhood Development in April, what happens to a child in those earliest years can make all the difference for a lifetime. Just 15 years ago, even scientists thought that baby's brain structure was virtually complete at birth Now, neuroscience tells us that it is a work in progress and that everything we do with a child has some kind of potential, physical influence on that rapidly forming brain. A one participant at the White House Conference put it, "nature and nurture don't compete, they cooperate." 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 07 Children's earliest experiences, the sights and sounds and smells and feelings they encounter, the challenges they meet, they determine how their brains are wired. For those of you who know a lot more about computers than I know, we're talking about how the brain shapes itself through repeated experiences. The more something is repeated, the stronger the neurocircuity becomes. And those connections in turn can be permanent. In this way, even the seemingly unimportant, totally forgettable events of our first years are anything but trivial. It is during this time that children learn to soothe themselves when they're upset, to empathize, to get along with others, to become and we hope they will, human beings of the finest order. Experiences in those first three years of life can also determine how well a child learns. When someone speaks, reads or plays with an infant or toddler, he or she, whether it is a parent, a grandparent, an older sibling or a care giver, is activating the connections in that child's brain that will one day enable her to think and read and speak and solve problems herself. Now, what that means is that subpar care, whether in the home or in a child care setting, means that a young brain is being deprived of what it needs to live up to its natural potential. Now that is a very serious conclusion for us to reach and now we have no more excuses. If we know that ignoring a child, being impatient, pushing off a 8 month old, or a 16 month old, failing to invest the time that is necessary in that two and a half year old, then we have to acknowledge, its not just a momentary action, but it adds to the past and the present and the feelings that that child is internalizing and it also literally affects the brain. Another reason we need to act is that we now have evidence that child care is too often inadequate, research presents a troubling picture. A recent national study of child care centers found that 70 percent of children are in care that is barely adequate. Ten percent are in care that is dangerous to their health and safety. Infants and toddlers are at the greatest risk with 40 percent in care that poses a threat to their health and well- 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 08 being. That means that they spend hours of their days with care givers who do not follow basic sanitary practices, who rarely cuddle, talk to or play with these infants and toddlers, n rooms that lack toys and other materials to encourage development and in places where the ratio of children to adults is too high for individual attention. Only twenty percent of our children are in what we could call "high quality care," such as what I saw this morning. A study of child care in family-based settings found equally disturbing patterns. Only 56 percent of these programs provided adequate care, 35 percent were deemed inadequate, which means as we now know, that the hours spent there could actually undercut a child's development and only 9 percent offered high-quality care which was defined as enhancing the growth and development of children and even where quality care is available, it is often financially out of reach for parents, particularly low income parents. According to the 1995 census, families earning under $1200.00 a month pay an average of 24 to 25 percent of their income for child care. That takes a big chunk out of a household budget but it was still not enough to ensure quality care I asked about the cost of the child care centers here on this Campus and there is a sliding scale which is very important, but it still costs between $340.00 and $600.00 a month. Middle class families are hit hard as well. Families earning up to $36,000. pay out 12 percent of their income for child care without any guarantee that that twelve percent is buying quality. It is difficult to think of a consumer situation in America where so many people are paying so much and too often getting so little. Another reason we need to act is that we now know from another study that was just completed by the National Institute for Child Health and Development that good child care can be beneficial to young children. Whether it is care given at home or in a day care center. Now, there's no doubt that the most important lasting influence on any child is that child's family. But we do 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 09 know that good, quality child care can improve a child's chances, if that child is in a difficult family situation or enhance a child's learning and maturity if that child is in a good family situation. And for children who come out of family situations that are not always conducive to their well-being, bad child care can make a difficult situation even worse. Now a final reason we need to act is because of the changing nature of the work force. We know that the Ainerican work force has changed dramatically in the past forty years and that has meant dramatic changes in family life. Half of all mothers with children under the age of one are working outside the home and not only are more parents working, they are working longer hours. So this issue must become a policy challenge for all of us because it clearly affects the well-being of children, American workers, and the dynamism of our economy itself. I would imagine that many of you who are parents and those of you who are students, not yet parents, can equally shut your eyes and imagine or think back to one of those work family conflicts that has occurred in all of our lives. Even though my daughter is a Freshman in College, I still remember vividly the days when my child care arrangements fell through and I was not able to do anything about them. Now, luckily for me those were very few because I have the kind of job where if my daughter were sick or if she had a special occasion that I wanted to take advantage of in her preschool or her school years, I could arrange my schedule. That is not the case for the vast majority of working Moms and Dads. I also have the advantage, except for two years of her life, to live in a Governor's Mansion where there were lots of people around, that is not a common experience for most working mothers. And so I'm very aware that my situation was unique but even with it, I recall vividly those few times when despite my best efforts and a very supportive husband, and all of the balancing we all do, it just all fell through and I had to scramble like crazy tb make up for it. One time in particular when I couldn't cancel something or just not go into work or go in 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 10 late, I had to be in court at nine o'clock and Chelsea was up all night sick and my babysitter was sick, probably with the same thing Chelsea was sick with and my husband was out of town and my family wasn't around and I called one of my best friends and she wasn't available, and it was just a real terrible feeling that you get when you know that you want to be with your child and because if work demands you can't and I was lucky enough to find a neighbor who could come in an sit with her and I called home every chance I had a break and rushed home when ] finished to find her you know, very well taken care of But, that is not what is available to most parents and I know it is infinitely tougher for most women who everyday are trying to do the bes!: they can. And I honestly don't know how single parents do it. And I think we ought to be very sympathetic and very supportive of all parents but particularly of single parents. Too many children end up because of their parents challenges, caring for themselves or being supervised by older siblings. And we know what happens when children are left unsupervised. According to the FBI, it is during the late afternoon that our youngest children, those who are in their pre-teens or early teens, are most likely to experiment with drugs, to become involved with criminal gangs, to get pregnant, to commit violence or to get into trouble in other ways. So, when that 3 o'clock bell rings, kids are relieved but a lot of working parents panic and we have to find a way to help parents with school age children as well. So, we know we need to act but where do we start. Well, we can learn from models of excellent child care around our country. They can provide the energy and expertise and inspiration for what we need to do now. One very bright spot is the military's child care system. Our Defense Department runs the largest child care system in the world. Taking care of the children of the parents who are in the front lines of America. I was privileged just two days at Quantico Marine Base to be able to see first hand what is being provided for the children of our Armed Forces and I have to say I saw what 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 11 every parent would want for her child. A beautiful facility, well-trained workers, hijh standards, unannounced inspections both in the Center and in the family day care settings, a tol free number for parents to call with their concerns, mandatory training for everyone that comes into contact with and works with a child. And, most importantly, good wages and solid benefits and respect for staff. Now, that has resulted in lower turnover and more experienced care givers. Now, that wasn't always the case and I learned in a very open discussion that the military's child care was not always what we would hold up as an example. In fact, even the Center that I visited Quantico is brand new because the previous one had to be shut down because it didn't make the grade a few years ago. But, the leadership of our military knows that readiness depends upon mothers and fathers being able to do their work without worrying about whose carings for their children. So the military made a commitment to turning its child care system around and Quantico is now a shining example of what can be done. I want to tell two stories that I heard. The first, from one of the Commanders there was what happens before good child care in the military. I heard about a mother and a father who were both called to duty on an emergency basis at the same time. I believe they were both pilots. They had to be in the ail at the same time. When that happened, they had to bring their two infants in basinettes' to the of fice of their Commander, leave those basinettes' in their Commander's office with instructions for care and feeding. Now, that beats any story about child care challenges that I've ever heard. The second story is about, "what happens now?" That there is quality care available no matter what the occasion. I met a Staff Sergeant, a single Dad, raising two little girls. He said that when he took his daughters to day care the first day they cried when he dropped them off, but the second day they cried when he came to pick them up. I was especially impressed by this very tough Marine whose obviously put in his time at the weight training facility, talking with great pride about how 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 12 he mastered pigtails and ponytails for his daughters but I think part of the reason his confidence is so high about embarking on the rather daunting task of being a single Dad of two little girls is because he's gotten a lot of support from the child care facility and the care giver's wao have been there, helping him along, encouraging him, giving them advice, helping to create that village. On a serious note also, we were privileged to have Lt. Colonel who I see n the audience here speak about the perspective of the child care system from the perspective of a commander. He said that his soldiers are more productive when they don't have to worry about their children. Now, I probably should say his Marines are more productive when they don't have to worry about their children and the result of that is a much higher level of preparedness 24 hours a day. Now, there are certainly differences between the military and civilian sector, but I believe that the military's experience can serve as a for the American work place in general. When parents don't have to come to work feeling concerned about how their children are doing, they can make a much more positive contribution which benefits all of us. Just before I visited Quantico I was in Miami at Baptist Hospital there that also has made a commitment to child care. I saw another first class facility, I learned about how they have adjusted the hours because just like the military they have 24 hour work days in a hospital and I heard a lot of detail from the Chief Executive Officer about why it is good economic sense to provide this service. I met at the hospital with the Board of Directors of something called, Florida's Child Care Executive Partnership, a group of business executives appointed by Governor Lawton Chiles to address child care issues. In creating this partnership, Florida put aside two million dollars the first year to match dollar for dollar Corporate contributions for child care. And the Board was charged with engaging the private sector in this effort. 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 13 Once asked, the Florida business community responded quickly and generously and his year the legislature and the business community are doubling their commitment so that we'reltaking both public dollars and pulling them to create more affordable quality child care and because of this effort, thousands of more working families in Florida now have access to the kind of care I saw at Quantico, I saw at Baptist Hospital, and I saw here at the University. Because we know that providing good child care requires community involvement The grant money in Florida only goes to communities where businesses have come together with child care organizations to forge a plan of action. And, when I ask these business leaders why they thought the partnership was successful, they didn't hesitate to answer in very business like terms. They said it was good for the bottom line. They said they didn't have to spend as much time recruiting new workers who left because of child care problems. They didn't have to spend as much money recruiting new workers who had to be trained. They didn't have to worry about absenteeism which had been dramatically. Now, that was also the experience of many other businesses with whom I have met and I just find it being repeated over and over again. So, because I find the partnership concept so impressive, I'm very pleased to announce today that the Department of Health and Human Services is awarding a half million dollar grant to the families and work institute, the National Governors' Association, and the Finance Project, to assist states in developing these partnerships with the private sector. And, the Preseni has earlier this year, the military, the Department of Defense, to work with the private sector, to take the experience they've gained, their guidelines which have been carefully written and bring those to the table to discuss with more child care centers and family day care providers what can be done to use money like that available in Florida to make models that can be replicated. Because all 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 14 sectors of society have to be involved, businesses, schools, police departments, religious organizations, libraries, citizens' associations, the Federal, the State, and the local governments We hope that the White House Conference will be a catalyst to bringing many of these sectors together. I also hope that at the White House Conference we will discuss ways that could assist parents who wish to make the choice to stay at home with their children more economically feasible because its not just creating good child care centers and family day care centers outside the home, how do we create real choices that are available to working families so that they in the privacy of their family can make a decision that it is economically feasible for one parent to be there for their children. It is important to remember that this Conference is a starting point. I hope that it marks the beginning of National discussion and action. And I hope that its focus on the three keys areas will spark individual ideas around the country. Now, the three key areas are the lack of affordable child care, quality concerns, and the need for school age care. We have already discussed affordability and we've made some progress. The President took some steps to address this need. For starters, the expanded Federal funding for child care. In fact, since 1993, child care funding has risen by approximately 68 percent and it now reaches more than one million children through subsidies which is critical if they're going to have financial access to quality care. And I'm encouraged too that in the last four years more states are committing their own resources to help working people pay for quality child care. In the balanced budget agreement, the $500 child tax credit will go to 27 million families with 45 million children under the age of 17. Now foi the typical American family with 2 kids, this child tax credit will mean 1,000 more dollars in take home pay 13 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 15 per year. That is especially important for low-income families who are also going to benefit from this child tax credit. Thirteen million children from families with incomes below $30,000 will receive the credit. That's a lot of young teachers, police officers, farmers, nurses and others who will have some extra income to put into whatever their family decides, but certainly one of the great expenses is improving child care. Also through the expanded Earned Income Tax Credit, more working families have had a cut in their taxes which has on average meant an increase in their income of over a thousand dollars. So, there have been real steps forward so that there's more child care available, it's subsidized, and there's more of an opportunity for families with children to take advantage of these programs. The President has also made child care an essential component of welfare reform. He insisted that welfare reform include spending for child care because we're putting a lot more women, single women with children, into the work force. So it will be increased by nearly $4 billion over the next 6 years. But that is still not enough and we have a long way to go to explore how better to enable parents to meet their child care costs. Quality is the second key issue. We have to do more to support child care providers. We have not done a good jbb of lifting up the profession that is so important in taking care of our children and matching that with increased income and job opportunities and benefits. I've been to a lot of child care centers and I've met many, many terrific people running and working in them but their salaries are woefully low and many leave the profession because it's not one that enables them to support themselves and their own families. I remember one provider who told me with tears in her eyes that with the birth of her second child, she had to leave taking care of children which is what she loved to do more than anything and go to work in an office because she needed to make more income. So we have to do all we can to encourage and support child care workers to get training, to build their skills and increase their 14 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 16 knowledge which will demand higher salaries and benefits. We have to find the very best people to take the jobs of caring for our children because parents should not have to worry whether their child is safe at day care and the vase majority of teachers are absolutely superb in caring for their children, but there a few who we need to make sure do not go into the classrooms of our day care centers. And we also have to help parents do a better job of searching out good child care. In survey after survey when parents are asked, they really don't know what they're looking for They don't know what kind of equipment should be there; they don't know what kind of training they would be demanding for the child care workers. Too often parents are better informed about what kind of car to buy than what kind of child care to choose. So we have to help parents become more informed consumers to create that demand that will absolutely say to the market place, we must have higher quality for the money we're paying. One of the interesting results of a lot of the research that has been done recently is that good quality child care is generally but now always more expensive than inadequate child care. And in the middle, there's a lot of child care that could be vastly improved with some good training and better guidance there would make a big difference for the money that is being paid. Now I hope that we will continue to focus on safeguarding the health and safety of children in our system around the country. Certainly the President earmarked money going to the states for child care for quality improvements. And this summer he proposed a new rule requiring that child care programs that receive Federal dollars make sure that all children are immunized. And in 1995 the administration launched the Healthy Child Care America Campaign which promotes partnerships between child care centers and health agencies. That initiative now in 46 states teaches child care centers how to create safe healthy environments. A lot of times when we do the ese surveys and we get the results and people go in and say, this isn't sanitary; this is not appropriate, the child 15 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 17 care workers don't know that. Nobody's told them. They're not sure about what thev're supposed to be doing. So through the Healthy Child Care America Campaign, we intend to do a better job of educating child care workers. And, finally, school age care. A critical issue for millions of working American families I have visited some excellent school age child care programs. The other day in Quantico, I visited one of their schools and saw what was available for the children there, but most children and their parents do not yet have access to good school age child care. Places where the children can do homework or play sports or learn to play a musical instrument Home Alone might have been a hit movie but it is not a good script for real childrens' lives and we need to move to make sure more children can safely and productively spend those after school hours in a place like i: school or a library or some other setting that is good for them. I'd like to close with one thought and then invite your questions. We are privileged to live in a time of tremendous bounty in our country. We are at peace. Our economy is booning. Social problems that for years held us back are receding. The crime rate is down, the teenage pregnancy rate is down. On 50 many fronts we're making progress together. At a time such as this presents a special opportunity free from crisis we can do work that might not be possible in stormier moments. So we should use this good fortune to make a difference, to lay the ground work so that the generations of children to come will be able themselves to build a country that has so many opportunities and take advantage of the blessings that we all have. So turning to child care is not just something that is a nice issue to talk about. It is as the President calls it, the next Great Frontier of Public Policy, to build up and strengthen our families, to give them more support so they can do their jobs both at home and in the work place will help up chart that Frontier not only SO that we are 16 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 18 led to a better world for the children I saw today, but for generations of American children to come. And I invite all of you to be part in taking action to make sure that happens. Thank you all very much. (applause) I'm glad there were babies here. That's a wonderful reminder of why this is so important. Well, as I understand what we're going to do ndw. We have two people with microphones in the isles. If anybody has any questions, they should line up behind the gentleman here and the young woman there and take a turn, but if not, that's all right, too, I don't mind at all. Hi. Hi. (Mrs. Clinton) I have a question. I'm am employee on campus. I've been a secretary here for fifteen years. I have a four year-old son. I'm a single mother. I wanted to get my son to go to school here at the nice center. It would cost me over $500 a month and my salary is $25,000 a year. So how can that help employees here on campus? And I'm not the only single mother that has had a problem with this. Mrs. Clinton - And that is one of the reasons why I mentioned that we have td do more to provide more slots in child care for working parents like yourself and we have to help subsidize quality child care because you are a perfect example of the problem that I'm trying to illustrate. You make $25,000 a year With no child support. Mrs. Clinton - with no child support. So that's your total income. Correct! Mrs. Clinton . And that's before taxes 17 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 19 Correct! And I live at home with my parents. Mrs. Clinton - And you're doing all you can to keep expenses down living at hone and good quality child care such as we see here at the university would cost $500 a month, which is $6,000 a year, which is a 25 percent of your before tax income. I mean that is exactly the problem that I'm talking about. So what have you done for child care? Well, I went to a Catholic school in the area and they gave me 8 scholarship for 1st this year. So I pay $200 a month to have him in full-time pre-K. But if I did not have that and ( didn't have my parents, I would probably have to quit my job and go on welfare because who would watch my child during the day and how could I afford that and live in an apartment. Mrs. Clinton - Well, that is the problem. I could not more vividly describe ii. And, so, I hope that some the proposals that will be discussed at the White House Conference, yo or child will be in school before we probably get much of the changes that I would like to see happen, but then you'll need, you know, after school care which is another part of this debate. But I hope that some of these proposals will focus exactly on what you're talking about. We need more subsidies for working families, particularly single parents. If we are going to have a policy in our country of ending welfare and expecting everyone to work, we have to do more to support those parents with children who are trying to do the best they can by working. And I want to thank you for what you're doing. (applause) Hi, I'm the Director at Galludette University Child Development Center and have worked with children with disabilities for the last 20 some years in child care and I'm curious what you all are suggesting the focus and direction more and more children with special needs are now in child care centers because of Special Ed laws and I'm curious where you all stand on that. 18 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 20 Mrs. Clinton - Well, we stand with you as an educator of children with specials needs and with parents of children with special needs because it is more expensive to care for a child with special needs. And, again, parents face the same difficulties, only more so because of the additional costs. And it's not just financial costs. It's also emotional and psychological costs that is much higher when you have a child, whether it's your only child, or one of a number of your children with special needs that you need help caring for and also for many children, you want to integrate them as early as possible into as typical a life as you can possibly arrange for them and that requires, often times, you know special transportation, special equipment, whether it's wheel chairs 01 other kinds of medical equipment, it often requires, in your case, with deaf children, specially trained caregivers. So this is an issue that is a part of our overall issue of quality and affordability. I am old enough to I keep saying that I think that's because I'm going to turn fifty this month. I'm old enough, I'm nearly a half century old. Think about it for all you young people. It's hard to believe it happens. (laughter) So I can remember (applause) many, many years ago when I worked for the Childrens Defense Fund and when I was involved in other activities concerning children, going into places where children with disabilities were literally just left on the floor all day. I cannot tell you some of the places I have seen. Now that was twenty-five years ago. I haven't seen places like that recently, but I'm not invited to those places in my current position and I know that there are lots of excellent facilities for special needs children and I know that there are some that are really very inadequate. So this is a big part of what we're going to be talking about. Yes. Thanks for coming. I'm a student here and I would like to know how does the European child care or World child care compare to the United States and are you planning to have any World input on planning for American child care. 19 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 21 Mrs. Clinton - That's an excellent question. I want to thank you for asking that because often times we don't learn about what works in other places and there are some very good models in Europe of National Commitment to Child Care. In fact when I was at the child care center here at the university, I learned this morning that the facility is modelled on facilities in northein Italy. The university architects went and visited because of the great room with the classrooms off the side and it's really something beautiful to behold. But there are some very good programs in a number of European countries that I think bear some attention. I have personally visited child care centers in France and in a few other countries, particularly in France and Denmark which were veri impressive to me because there was a national commitment to the provision of quality affordable child care that went beyond political ideology. I remember when I visited France, I went to various cities and looked at their child care facilities and whether I was in a city that was run by a very conservative mayor and city council or one run by the socialists party, I didn't see any difference. And I asked a very conservative mayor in a French city how he could explain this national consensus about spending both national and local dollars to build excellent facilities, make them affordable, and he said but they're all our children. You know we are creating future French citizens and he said it as only a Frenchman could say it with a lot of flourish. It was like I asking such a ridiculo IS question. How could politics have anything to do with taking care of one's children. They fight about other things and even in the recent efforts to reign in the budgets in a lot of the European countries to make them more economically competitive, their caring for children has not been an issue of debate between the political factions in the countries that I'm aware of. They are going to remair committed to universal health care for all of their people and for adequate education and child care for preschool and I think it's a very important National commitment and I think we should look to she if we can 20 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 22 learn anything from that. I write a little bit about the French system in my book because I was impressed by it. Yes. Being college students, most of us don't recognize there's a problem in child care but also being very involved in community service, what can we do as college students? Mrs. Clinton - That's also a very good question and I think community service is a critical key to being able to provide enough voluntary manpower to help out in a lot of the centers that are particularly serving lower income families. And I know that a number of young people both through university community services and through Americore have signed up to work on things like America Reads and mentoring and tutoring children and I think looking for opportunities to work with even younger children to give them the attention that they need would be a very good way of working with at least one family, one child. Maybe showing a mom or a dad how to read to a child with just by you doing it, modelling it for them, playing, teaching some of those silly games and songs that you were taught all of which help build the brain. I mean all those little things that we used to do all make a difference. And you know there's a lot of evidence now that you know young women, young mothers when they speak to children in those little high voices we all adopt when we see little kids. Like oh, oh Michael, you're so cute. You know our voices just go up like, you know, full register. That has an impact The child really can hear it. And young men and fathers who are more physical with babies and, you know, play games with them, that also stimul the brain development. So there's a lot that both young men and women could do in giving of their time to work with some of these kids, especially as I say in lower income family areas where there may be too many adults taking care, too few adults taking care of too many children. Good afternoon. My name is Cecilia Johnson and I'm a family child care provider and I have 21 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 23 been for twenty years. My question is of the eight parents that I have who are single mothers, one who just recently came off of welfare, the biggest problem that they undertake is getting benefits from the jobs in which they work to help take care of their children, especially medical benefits. And with the rising costs of child care and the costs of taking care of your child, I would like to know how do we plan to help our single mothers who can't get benefits from their jobs to help take care of their children. Mrs. Clinton - Thank you for asking that and thank you for being a family day Care provider. Until we have some program that takes care of all of our childrens' health care needs, we will not solve this problem completely, but in the Balanced Budget Agreement, we made a big step forward as a Nation. Because through the commitment of $24 billion that was raised by raising the tax on tobacco, we will be able to provide health care for half the children who are currently uninsured, many of whom fall into the category you're talking about. Now a lot of mothers getting off of welfare should be very sure they're not still eligible for Medicaid because they often are. We have 3 million children in America who are eligible for Medicaid but their mothers and fathers don't know they are so they are left to the whims of the emergency room or not being taking care of. So making sure your eight moms check to see whether they're available and eligible is the first thing. Secondly, this new money - this $24 billion will expand coverage in every state. So making sure they know where to go to find out how to sign up their child for health care I think is the best advice you could give them and to help them, you know, know where to contact somebody and to try to find out. But we still have too many Americans who do not get health insurance through their work, are not eligible for any kind of government assistance, and they just fall into this large pool of 40 million uninsured Americans, about 11 million of whom are children. And so we just have to keep making 22 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 24 sure everybody who's covered with Medicaid and the new Child Health Program are covered, then we need to see what else we're going to do to cover the remaining children and adults. So please give them that information. Mrs. Clinton, I hate to do this but your staff has suggested that you maybe should take only one more question. Mrs. Clinton - All right. Well, actually instead of a question I wanted to issue an invitation to you to (ome visit me at the Childrens Developmental Clinic on this campus. Come back one more time this Saturday and see a new program or different program from what we've been talking about today, which is undergraduate and faculty members volunteering their time on Saturdays to play with the children, provide role models for the children, and to deal with those hours of concern that you mention for late afternoon hours, excuse me, the week days when they are unsupervised. And the special thing about our program is that it's for children with physical disabilities, who have self-esteem issues and who get isolated at schools and also children from disadvantaged neighborhoods, from disadvantaged backgrounds. I work with children from the Cools Spring Elementary School who are Hispanic mostly and who have parents who are very disengaged from education and if you ever have the time to come visit us on Saturday, I'd love to show you what can happen when people volunteer for free. expenses Mrs. Clinton - Well, the young man who asked the question what he might dd, you need to sign him up. (laughter & applause) Well, unfortunately I can't be there this Saturday laughter) but I'm very glad you stood up to invite me and did such a good job describing what you do because I 23 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 25 think that's the kind of a model that more people need to hear about That there is some hing literally for everybody to do. Whether it's in our own homes spending more time with our own children, maybe the children next door or down the block or if somebody else in your family who doesn't have the time and is working too hard and needs a helping hand, or whether it's being involved professionally as so many of you are as child care providers at a center or in a home: We all have something we can do and volunteering to help support parents and child care providers is a very important way of not only providing a service but for each of us to know firsthand what you know about what a difference it can make in a child's life. And so I hope that you'll be engaged in this issue and thinking about it and sharing ideas and here on this campus try to reach out o everybody, you know, whether it's the young people who are at this center or the young women who stood up who is working here as a secretary already who needs some support, needs a helping hand. I bet if everybody on this campus just looked around at the people you already know, you'd find that there's something you can do to help relieve some of the burdens of taking care of children, especially for single parents. I really want to stress that. It is so important that we support them and give them the kind of attention and volunteer activities that will enable them to know they're being good moms and dads because that's what everybody wants to feel. And if we could get that idea across, I think a lot of our other problems in this country would take care of themselves. Thank you very much. (applause) President Kirwan --Mrs. Clinton I hope that you can sense the very strong and special feelings of support there are on this campus for you and the work that you're doing and also sense how honored we are to have you at College Park. We know that during school breaks, there will I kely be some colors of another school prominent in the White House (laughter) and we think you need to be able 24 10/03/1997 17:42 3013149344 UNIV RELS PUBLICATNS PAGE 26 to retaliate with the colors of one of your schools. So we have a little gift we want tc give to your that we hope you'll wear when Chelsea is home. Mrs. Clinton - Absolutely! (applause) 25