Updated: September 14, 2020
The public health emergency created by COVID-19 presents an array of unprecedented challenges for America’s elected leaders. As the nation seeks to slow the spread of the virus – while retaining the ability of medical professionals and other essential staff to fulfill their valuable roles – one industry stands squarely in the gap, holding the potential to powerfully shape the effectiveness of these efforts: child care.
In order to ensure care for the children of first responders amidst school closures and a growing number of stay at home orders, child care providers – many of whom are being asked to take on hazardous duty for the good of the nation – must reasonably be placed into the first responder category themselves. But what might this look like for one of the nation’s most chronically under-resourced workforces?
Likewise, the fiscal solvency and long-term viability of child care businesses stand to be directly impacted by the pandemic – with small business owners across the nation already expressing concern about their ability to reopen following what may be months of closure for programs not electing (or able) to remain in operation as a support to essential staff.
As states prepare to implement emergency child care policy options, this brief is designed to address key considerations for policymakers and highlight examples of potentially effective state practices already emerging over the first weeks of the nation’s response to COVID-19.
With pubic health authorities urging social distancing to slow the spread of COVID-19, Governors are taking aggressive action to prevent community spread, closing schools and ordering the physical closure of non-essential businesses.
The question of how to care for the children of essential staff, however, presents a troubling conundrum for states: how can the nation keep employees at work within life-sustaining professions while mitigating the very real dangers associated with providing group care to the children of this high-risk population? Though young children are not presenting with serious symptoms at anywhere near the same frequency as adults, they are not immune to the virus, can experience serious complications, and are known to be (sometimes asymptomatic) carriers – posing a potential danger to both their teachers and classmates and to their family members serving in indispensable public safety roles.
Governors across the nation are taking reasonable first steps here, ranging from enhanced health and safety requirements to closing child care to the children of non-essential employees.
The Hunt Institute is maintaining a real-time compendium of state child care closures and other actions in response to COVID-19. Based on this analysis, all states choosing to shutter child care for the general public are making special accommodations to ensure its ongoing availability to the children of essential staff.
In doing so, a growing number of states are requiring centers to seek emergency approvals and/or specific pandemic licensure, typically through a very simplified application process and accompanied by both enhanced health and safety requirements and the emergency suspension of certain regulatory requirements.
Ohio, for example, is issuing Temporary Pandemic Child Care licenses to providers wishing to remain in operation. These short-term licenses limit service provision to children whose parents are employed providing health, safety, and other essential services, with classroom group sizes limited to six children (among other requirements).
These temporary licenses have several advantages. First, by suspending all child care operations not covered by emergency licensure or approvals, states can monitor in real time the availability of care, matching essential employees to programs certified to support their needs.
Second, these simplified licenses lend themselves to the creation of temporary child care sites, often located on-site or in close proximity to the facilities (hospitals, for example) in which parents in need are serving as essential staff. While clearly convenient – and in some cases badly needed – policymakers should consider temporary applications carefully and on a case-by-case basis, recognizing that existing facilities designed, staffed, and equipped to meet the needs of young children (in particular) may already exist in close proximity.
As states take steps to address new and unexpected circumstances arising from the COVID-19 outbreak, many are temporarily suspending or relaxing specific regulatory standards. This is a practice that simultaneously makes good sense and requires terrific circumspection on the part of policymakers.
While it may be reasonable to relax certain requirements (temporarily extending the expiration dates on required teacher trainings that may not be readily available for renewal as a result of social distancing orders, for example), policymakers should exercise great judgement when acting to relax or suspend requirements designed to protect the health and safety of young children.
One place to exercise caution, for example, is the relaxation of requirements related to fingerprinting and criminal background checks prior to employment as a child care teacher. While several states are providing increased flexibility even here – citing the closure of private companies which provide these services as a partial rationale – it is important to recognize that a sizable, existing child care workforce exists for whom these checks have already been completed.
Of course, newly established emergency child care sites will need to staff up, but – for a wide variety of reasons – these new centers are wise to employ trained temporary staff who have been thoroughly pre-vetted (a workforce which, in large numbers, may find itself sidelined or unemployed during this time).
Though the need for child care may be inextricably linked to the ability of essential staff to provide life-sustaining care, the ultimate wisdom of group child care during a highly contagious pandemic may need to be reconsidered by policymakers, particularly as some public health officials suggest limiting gatherings to stable groups of five or fewer. This may be especially true for the children of essential staff at high-risk of direct daily exposure to the virus, who – through their participation in classroom groupings – may increase the likelihood of community spread to both their teachers and the families of other essential workers.
While states are wisely limiting the size of classroom groupings within emergency care situations – and should continue to do so for the safety of all – policymakers may also be wise to consider alternate, one-on-one care options, including the expansion of paid family leave policies and/or the provision of cash payments/vouchers with which essential staff can arrange for compensated family, friend, and neighbor care in trusted home-based settings as a short term alternative to center-based group care (which, for essential staff, is already being underwritten financially by many states). Though unlikely to wholly eliminate the need for group care (whether in centers or family child care homes), the inclusion – and active promotion – of one-on-one care options is worthy of strong consideration in the fight to slow community spread, as is consideration of still smaller groupings for group care providers still in operation.
America’s child care workforce is poorly compensated during the best of times, with one recent analysis concluding that 46% of the nation’s child care workers are enrolled in at least one form of pubic assistance. Subsisting on hourly work at or near minimum wages, much of this workforce lacks both paid time off and employer paid healthcare benefits. As this under-resourced workforce is asked to take on increasingly hazardous duty in the name of protecting public safety during the COVID-19 outbreak, it is appropriate that states consider action to address both the compensation and healthcare needs of workers putting themselves and their own families in harm’s way by providing this essential service.
While still early in the nation’s response to COVID-19, North Carolina has established itself as a leader on the compensation front, guaranteeing child care teachers bonus pay of $300 per month during both April and May of 2020 (and non-teaching staff a monthly bonus of $200).
While not enacted at the time of this writing, legislation filed in Wisconsin would create a Hazard Pay Grant Program, through which the state’s Department of Children and Families would “make monthly grants available to certified child care providers, licensed or provisionally licensed child care centers, and child care providers contracted by or established by a school board for providing hazard pay to employees who work during the public health emergency.”
Just as it is unreasonable to ask child care providers to perform potentially hazardous work without adequate compensation, the healthcare needs of this workforce are also worthy of immediate consideration by policymakers, particularly as these employees are being asked to provide care for the families of a particularly high-risk population.
On March 18, 2020, New Mexico Governor Michelle Lujan Grisham took steps to secure the healthcare needs of the state’s child care workforce, announcing that the state will pay the cost of premiums so that uninsured child care workers who test positive for COVID-19 (and are not eligible for other coverage) will be allowed to enroll in the New Mexico Medical Insurance Pool (NMMIP) – the state’s high-risk pool – and receive comprehensive health care coverage until they recover. The opportunity will be available to both child care employees and the members of their immediate households, regardless of income or immigration status.
“NMMIP is chaired by New Mexico’s Superintendent of Insurance; it provides comprehensive health coverage for people who have significant medical conditions, are uninsured, and are not currently eligible for other coverage (such as Medicaid or Medicare). The board of NMMIP held an emergency meeting on March 6 and voted to include COVID-19 as one of its covered conditions, which triggers expedited enrollment.
NMMIP does charge premiums to enrollees. The state of New Mexico will cover the premium costs for all uninsured child care workers with COVID-19 and their immediate household members who obtain coverage through NMMIP. Under emergency rules issued by the Superintendent of Insurance, deductibles and copayments are waived for treatment of COVID-19, influenza and pneumonia through NMMIP.”
Finally, to prevent the potential collapse of the child care industry and ensure its continued availability to the public at the conclusion of this crisis, a growing number of states are stepping in to provide fiscal supports to child care businesses. (Note: This topic is covered extensively in a dedicated brief from The Hunt Institute.)
At the time of this writing, perhaps no state is moving as aggressively to ensure the ongoing solvency of its state’s child care providers as Vermont.
While many states – Vermont included – are taking steps to ensure the continued flow of both state prekindergarten funds and federal child care subsidy payments to participating centers (permitting programs to be paid based on children enrolled, as opposed to real-time attendance during the closure period), Vermont has concurrently enacted the nation’s first child care stabilization initiative to replace the lost tuition payments of parents during the closure period.
During the state’s initial closure period from March 18 – April 5, 2020 the State of Vermont will, as needed, cover 100% of tuition not paid to providers on behalf of enrolled families (who are requested to pay this rate in full, but permitted to opt out on the basis of financial hardship independent of income), along with co-pays for subsidized families and any remaining costs to meet the provider rate. Effective April 6, 2020, parents will be requested to pay 50% of the regular rate with the state providing the remainder. In the event that parents unenroll during this period, providers will be eligible to receive 100% tuition from the state.
Additional grant programs to support the ongoing sustainability of child care have already been announced in Indiana, Minnesota, North Dakota, and Tennessee, all discussed in greater detail within The Hunt Institute’s State COVID-19 Fiscal Supports for Child Care.
As policymakers seek to address the needs of both families and child care providers during the unprecedented public health emergency created by COVID-19, the following policy considerations are worthy of deliberation as emergency child care plans are developed: