How Do Child Care Subsidy Policies Affect Access to Child Care for Young Children with Disabilities?

 

Background: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 vulnerable group of families. Specifically, high-quality child care may confer developmental benefits or connect families to other supportive services.  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 increase access for children with special needs, understanding the impact of disparate policy designs is crucial to effectively support these children and their families. Thus, this study seeks to understand whether CCDF policies to prioritize children with disabilities increase the use of child care for this vulnerable group of children and families.

Data/Methods: 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 children under 18, including an oversample of children with special healthcare needs (e.g., developmental delay).  We focus on the sample of children under 5 (N=11,996), 11% of whom are identified as having a special healthcare need.  We conduct descriptive analyses, including logistic regression analyses, to investigate the relationship between state policy and child care use (regardless of type of care).  When sample sizes permit, we disaggregate by specific health conditions.

Results: 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. We find 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).  

Conclusions/Implications: Findings that guaranteeing subsidies may increase access to child care for young children with disabilities can inform social work practice at the structural and individual levels. This study has implications for practitioners working directly with this vulnerable group of children and families and seeking to connect them to needed resources. At the macro-level, findings are particularly salient as states consider how best to improve access to child care to support young children with disabilities and families. Given the many challenges facing parents of young children with disabilities, this paper can address how the social work community can best advocate for one set of crucial supports.