Association for Public Policy Analysis & Management

Child care subsidies provide an important work support for low-income families, yet children often receive subsidies for only a short period of time. Short spells of subsidy receipt have raised concerns that subsidy instability may contribute to instability in child care arrangements. In reauthorizing the Child Care and Development Block Grant (CCDBG) in 2014, Congress cited research demonstrating the importance of continuity of care for children’s positive development. Proposed rules under the reauthorization require states to “describe and demonstrate that eligibility determination and redetermination processes promote continuity of care for children and stability for families receiving CCDF services” (Federal Registerv.80 (247), pp. 80479). 

Much of the research to date on patterns of subsidy participation has focused on the duration of participation, and less attention has been paid to the dynamics of how often and how quickly children return to the program. This paper uses survival analysis methods to analyze administrative data from Maryland in order to understand patterns of returns to the subsidy program after a break in subsidized care. In particular, we focus on the relationship between returns to the subsidy program and eligibility processes and rules. Having to re-authorize an arrangement or re-certify eligibility can be a burden for families and may affect the chances that eligible families will maintain or return to subsidy participation. Returns to the subsidy program, especially if they occur quickly, may indicate that the break in participation was unintended. These findings have important implications for increasing the effectiveness of program policies and implementation practices in the child care subsidy program.

Using five years of administrative data on child care subsidy receipt from Maryland, we describe the overall pattern of returns to subsidy and examine the relationships between child, family, and provider characteristics, as well as subsidy policy, and returns to subsidized care. We estimate both a Cox proportional hazards model for returning to subsidy, and a competing risk model to differentiate between returns to the same or a different provider. Using survival analysis methods to analyze returns accounts for right-censoring, which is critically important since about half of the children did not return to the subsidy program in the five-year study period. Returns to subsidized care are related to family circumstances, type of care, child age, and program policies related to eligibility redetermination. These characteristics have differential effects on the probability of returning to the same provider or a different provider, which may have important implications for the stability of children’s care. Given the importance of stability for children’s development, understanding the experience of parents and children in the child care subsidy program is important to inform policy and program procedures. Research-based evidence of the influence of eligibility redetermination policies and practices has been used by Maryland in restructuring the administration of the subsidy program. This research was conducted as part of the Maryland-Minnesota Child Care Research Partnership.