Subsidy Implementation from the Provider Perspective: Provider Experiences with Child Care Subsidies

Background and Purpose: There is mounting interest among policymakers in advancing understanding about provider experiences with the child care subsidy system with the goal of capitalizing on program strengths and reducing barriers to subsidy participation. Several recent studies suggest that program implementation challenges complicate client experiences with the subsidy program leading to premature exits (e.g., Henly, Kim, Sandstrom, Pilarz, & Claessens, 2017; Barnes & Henly, 2018). Relatively few studies consider subsidy implementation from the perspective of providers. Yet, there are considerable administrative tasks related to assisting parents with subsidy enrollment, maintaining clients in care, and keeping track of state payments that are required of providers.

To respond to this void of knowledge about provider perspectives, we provide an exploratory and grounded understanding of provider experiences with subsidy implementation. We address two research questions:  (1) From the perspective of subsidized providers, what factors facilitate or impede low-income families’ ability to enroll in and maintain enrollment in the child care subsidy program? (2) What strategies do subsidized providers employ to help families enroll and stay enrolled in the program?

Methods: Data come from the IL/NY Child Care Research Partnership, a multi-component study aimed at advancing knowledge of factors contributing to quality, stable subsidized care. This analysis draws from semi-structured interviews with 84 subsidized child care providers in two regions in IL (48) and two regions in NY (36). The sample includes center directors (31), family childcare providers (37), and license-exempt caregivers (16). Providers were purposively sampled from administrative state records to maximize variation by provider type, size, and subsidy density. Interviews were recorded, transcribed, and content analyzed, using a priori and emergent, invivo themes. Every sixth interview was double coded, and reliability was above 90 percent.  

Findings: (RQ1) Providers identified several eligibility challenges and bureaucratic barriers contributing to their own and client difficulties using the subsidy program. Most common eligibility concerns included beliefs that income limits were set too low and job requirements too stringent. Bureaucratic barriers included communication difficulties, paperwork snafus, and reimbursement delays due to under-resourced offices, overburdened staff, and outdated processing systems.

(RQ2) Providers reported several strategies to support families including reminders about recertification deadlines, advice on completing paperwork, delivering paperwork to subsidy office, and advocating for families to maintain or reinstate benefits. Some providers allowed families to stay in care during a break in subsidy without payment or with a reduced payment, while others terminated parents immediately upon subsidy loss. Not all providers viewed it as their responsibility or reported having the resources to help parents stay in care through a subsidy loss.