Financing Child Care in the United States - Ewing Marion Kauffman ...

HEALTH
Child health and safety in child care settings pose serious public health concerns. Also of
concern is the fact that child care employees are often without health insurance coverage,
since many child care programs do not provide health insurance as a benefit to their staff,
and wages are typically too low to allow staff to purchase health insurance on their own.
States have started to tackle these problems through their public health, tobacco and
Medicaid financing streams.
In Pennsylvania, the American Academy of Pediatrics
(AAP) developed a model child care public health
program. Known as the Early Childhood Education
Linkage System (ECELS), the program combines federal
maternal and child health funds with the federally
allocated, state–controlled Child Care and Development
Fund (CCDF) dollars. New Hampshire has elected to use
state health funds to support after–school programs
through PlusTime New Hampshire, as part of its public
health prevention strategy.
Child care analysts eagerly anticipated state tobacco
settlement funds as a source of public revenue that could
be allocated for child care. Maine took the lead in
earmarking a substantial proportion of its tobacco funding
for a comprehensive early childhood initiative. Maine is
joined by a few other states, but the tobacco funds have
not yet been tapped routinely as a child care funding
stream. For up–to–date information on the use of the
tobacco money see The Finance Project’s website,
www.financeproject.org or the National Conference of
State Legislatures, www.ncsl.org.
Some states are exploring use of publicly–supported
adult health insurance programs to meet the needs of
working adults who do not have access to health
insurance. Since child care teachers and providers often
fall within the stringent definitions of poverty and
near–poverty demanded for participation, these efforts
offer a new opportunity from which child care staff may
benefit. Two funding streams for this approach include
Medicaid and the tobacco settlement funds. Rhode
Island’s effort is already in operation, leveraging Medicaid
dollars to increase the availability of health insurance for
child care staff. For up–to–date information on progress
in health insurance coverage for working adults, including
child care teachers and providers, contact Jocelyn Guyer,
Policy Analyst, Center on Budget and Policy Priorities,
820 First Street, NE, Suite 510, Washington DC 20002,
(202) 408 1080, E–mail: jguyer@cbpp.org
56