When reauthorizing the Child Care and Development Block Grant in 2014, Congress added an important new purpose, “to increase the number and percentage of low-income children in high-quality settings” (Senate Report No. 113–138, 2014, p. 26). CCDF Lead Agencies are now required to target certain populations in their efforts to increase the supply and improve the quality of child care. One of these populations is infants and toddlers. Strategies identified by the Administration for Children and Families (ACF) to build and sustain the supply of high-quality care for infants and toddlers include the following (Administration for Children and Families, 2015):

• Set payment rates that adequately support high-quality infant and toddler care
• Offer financial incentives (such as tiered reimbursements) linked to higher quality care for infants and toddlers
• Offer direct contracts and grants to build infant and toddler care supply
• Expand the number of high-quality family child care options for infants and toddlers
• Expand the supply of highly qualified infant and toddler care teachers
• Use the Early Head Start–Child Care partnership model
• Increase the number of child care facilities tailored to the needs of infants and toddlers

Examples of State and Territory Efforts

The following policies and practices are examples of State and Territory efforts to implement supply-building strategies for infant and toddler care.

Providing Sustainable Cash Flow for Child Care Providers

A sustainable cash flow to child care providers supports the financial stability of programs and, subsequently, their ability to provide continuity of care to infants and toddlers.

• To help defray the higher cost of care, States or Territories can offer higher subsidy-reimbursement rates to programs providing infant and toddler care than to programs serving older children
• States or Territories can contract slots for infants and toddlers from low-income families, particularly in a geographic area with higher demand than supply

Supporting Quality Improvement and Administrative Stability

Helping providers improve their quality of care and administrative stability helps them qualify for higher reimbursement rates, financial incentives, or contracts for slots, and makes their programs more sought after by parents.

The following policies and practices increase the likelihood that providers will have more stable and sustainable businesses, which helps support better care for infants and toddlers:

• Establish or expand high-quality, community-based child and family development centers or neighborhood-based family resource centers. Such centers may serve as the hub for eligible providers, improving their capacity to offer high-quality, age-appropriate care to infants and toddlers from low-income families
• Establish or expand community-based family child care networks (Senate Report No. 113–138, 2014, p. 22)
• Provide training and professional development to promote and expand “child care providers’ ability to provide developmentally appropriate services for infants and toddlers” (81 F.R. 67524)
• Provide coaching and/or technical assistance about infants’ and toddlers’ unique needs from statewide networks of qualified infant and toddler specialists
• “Coordinate services with early intervention specialists who provide services for infants and toddlers with disabilities under Part C of the Individuals with Disabilities Education Act” (Senate Report No. 113–138, 2014, p. 22)
• Develop components focused specifically on infant and toddler care within the State or Territory’s quality rating and improvement system (QRIS) or other quality initiatives
• Develop components focused specifically on infant and toddler care within the State or Territory’s child care licensing regulations
• Develop components focused specifically on infant and toddler care within the early learning and development guidelines
• Develop activities that “will lead to improved infant and toddler health and safety, infant and toddler development, or infant and toddler well-being” (Senate Report No. 113–138, 2014, p. 45)

Supporting Low-Income Families

Support for low-income families as financially reliable clients of child care programs helps child care programs be more financially stable. Information below has been excerpted from the Overview of 2016 Child Care and Development Fund Final Rule (2016, p. 3–4)

• Establishing minimum twelve-month eligibility periods
• Allowing states to end assistance prior to the end of the eligibility period only in limited circumstances: loss of job or cessation of attendance at a job training or education program, excessive unexplained absences, change in residency outside of State, and substantiated fraud or intentional program violations
• Establishing a graduated phase-out of subsidies for families who, at eligibility redetermination, exceed initial State income thresholds but still have modest incomes; this would extend assistance until families exceed 85% of state median income or a lower income level that still accommodates some increase in family income and reasonably allows a family to continue accessing care
• Requiring states to offer a minimum of three months of continued assistance (at least at the same level) if they choose to terminate assistance if a family suffers a non-temporary job loss or stops participating (for more than a temporary period) in training or education
• Requiring states to take the cost of providing quality child care into account when setting provider subsidy payment rates, and to use valid methodologies to update rates at least every three years
• Allowing the public to participate in the state’s decision-making process around the setting of reimbursement rates
• Requiring states to show how base payment rates enable providers to meet health, safety, quality, and staffing requirements
• Providing for affordable co-payments that are not a barrier to families’ ability to access quality care and requiring states to monitor, and limit if applicable, any additional fees a provider may charge above the copayment
• Building the supply and quality of care for priority and vulnerable populations, including promoting services for children experiencing homelessness

References

Administration for Children and Families, U.S. Department of Health and Human Services. (2015, November 6).Information memorandum: Building the supply of high-quality child care. Retrieved from
http://www.acf.hhs.gov/sites/default/files/occ/ccdf_acf_im_2015_02.pdf

Administration for Children and Families, U.S., Department of Health and Human Services. 2016, (September 30, 2016).Overview of 2016 Child Care and Development Fund Final Rule. Retrieved January 5, 2017 from
https://www.acf.hhs.gov/sites/default/files/documents/occ/ccdf_final_rule_fact_sheet.pdf

Child Care and Development Fund (CCDF) Program, 81 Fed. Reg. 67438 (September 30, 2016) (codified at 45 C.F.R. Part 98). Retrieved January 5, 2017, from
https://www.gpo.gov/fdsys/pkg/FR-2016-09-30/pdf/2016-22986.pdf

Senate Report No. 113–138, Child Care and Development Block Grant Act of 2014. (2014). Retrieved December 15, 2016, from
https://www.congress.gov/113/crpt/srpt138/CRPT-113srpt138.pdf

Additional Resources

Frein B. (2016). Strategies for building quality infant-toddler supply. Paper presented at the Quality Rating and Improvement System Annual Conference—Establishing an Ecosystem for High-Quality Early Learning, New Orleans, LA. Retrieved November 21, 2016.

National Center on Child Care Professional Development Systems and Workforce Initiatives, Office of Child Care and Office of Head Start, Administration for Children and Families, U.S. Department of Health and Human Services. (2012). Infant and toddler continuity of care assessment tool. Retrieved November 21, 2016, from
https://childcareta.acf.hhs.gov/resource/infant-and-toddler-continuity-care-assessment-tool

Stoney, L. (2015). Financing high-quality center-based infant-toddler care: Options and opportunities. (Report by Early Educator Central to the Office of Child Care and the Office of Head Start, U.S. Department of Health and Human Services). Retrieved November 21, 2016, from
https://earlyeducatorcentral.acf.hhs.gov/sites/default/files/resources/Financing.pdf