How Do Child Care Subsidy Policies Affect Access to Child Care for Young Children with Disabilities?
*Names in bold indicate Presenter
Families raising young children with disabilities are a growing population who face steep challenges to locating and affording high-quality child care for their children, which in turn affects parental employment. These families are disproportionately likely to be economically disadvantaged, and maternal employment rates remain lower than the general population. Child care subsidies funded by the Child Care and Development Fund (CCDF) are a crucial employment support for low-income families and may be particularly salient for this group of families. In recognition of challenges to access for children with disabilities and that not all eligible families receive subsidies, some states prioritize children with disabilities; others guarantee subsidies. Currently little is known about the role of policy design in supporting access for these families. Since the 2014 reauthorization of Child Care Development Block Grant requires states to target policies to increase child care access for children with special needs, understanding the impact of disparate policy designs may be particularly relevant for policymakers and other stakeholders. Thus, this study seeks to understand whether CCDF policies to prioritize children with disabilities increase the use of child care for these families.
We merge state-level policy data from the CCDF Policies Database with child-level data from the 2016 National Survey of Children’s Health (NSCH), a nationally-representative sample of non-institutionalized children under 18 years, including an oversample of children with special healthcare needs (e.g., developmental delay). We focus on the sample of children under 5 years (N=11,996), 11% of whom are identified as having a special health care need. We conduct descriptive analyses, including logistic regression analyses, to investigate the relationship between state policy and use of child care (regardless of type of care). When sample sizes permit, we disaggregate by specific health conditions to further investigate heterogenous nature of the disability construct.
In 2016, 6 states guaranteed subsidies for children with special needs, 19 states prioritized children with special needs over other children but did not guarantee subsidies, 13 states gave the same priority as other eligible children, 10 had no discernible relevant policy, and 3 had variable policies. Preliminary results suggest that 72% of young children with special needs in states that guarantee subsidies for children with special needs were in regular child care compared to 63% in states that prioritize these children but do not guarantee subsidies (p<.05).
As states consider how best to improve access to child care to support child development and parental employment for this vulnerable group of young children, findings from this paper may be particularly salient. Given the combination of policymakers’ recent focus on improving access to child care for children with special healthcare needs and the dearth of empirical evidence about the efficacy of current policies, this study has important implications for the design and implementation of relevant child care policy.