Last year, the governor’s budget proposed to pay early care and education providers different amounts based on the quality of care they provide. Called “tiered reimbursement,” his plan would have used training, education, and accreditation to determine the rates that providers get paid by the state to care for children in low-income families. The plan would also have cut rates to most providers, so advocates spearheaded a successful campaign to defeat it.

Later in the year, the legislature passed a bill that would have set up a quality rating system for child care providers. Though at least 35 states have a quality rating system, the governor vetoed the bill.

Many advocates support paying providers more for higher-quality care—but they are also concerned about potential pitfalls. “I think that California will eventually (have) tiered reimbursement,” says Donita Stromgren, public policy manager of the California Child Care Research and Referral Network. “We need to be careful that (it) benefit(s) children.”

Good or bad?

Supporters say “tiered reimbursement” would:

• reward quality

• encourage providers to get more training: “It would motivate providers to go the extra mile of getting their degree or just being educated in child development,” says Elda Fontenot, second vice president of the California Association for Family Child Care.

• encourage licensed-exempt providers to become licensed. (Providers don’t need a license if they care for children of just one family besides their own.)

• result in better programs for children: “We know from research that the higher the quality of the program, the more the child will benefit,” says Paul Miller, executive director of Kidango.

Opponents say:

• Quality is hard to define (see What’s “quality” child care?).

• Tiered reimbursement could create a “two-tiered system”: “In the higher-income areas, a provider who (goes) to school can charge higher-income parents more. In lower-income areas, families can’t pay higher fees, (so) you could create more of a two-tiered system” with higher quality care in wealthier areas, cautions Nancy Strohl, executive director of the Child Care Law Center (Strohl supports tiered reimbursement—and paying all providers more).

Scaling up or down?

A system that pays providers based on quality could:

• Pay more: keep lower-quality providers at current rates and pay more to higher-quality programs. “I feel I should be compensated for all of the education and time I’ve taken.” says Fontenot. Paying providers more could “promote continuous quality improvement for teachers and early childhood programs,” adds Amanda Stangis, interim executive director of the California Association for the Education of Young Children.

• Pay less: keep higher-quality providers at current rates and pay less to lower-quality programs. Advocates say this would hurt children—because the state already pays too little for high-quality programs. “People think that if you take the same amount of money and spend it differently that you can change things,” says Strohl, “but you don’t want to increase quality to some kids at the expense of so many others.”

What about license-exempt providers?

Advocates disagree on whether license-exempt providers should be paid more or less than they are now:

• Paid more, to support parent choice: Parents using exempt-care providers are generally low-income, as are the providers themselves, notes Michelle Stewart, coordinator for the Contra Costa chapter of Parent Voices. “Family members stop going to work to help the parents of the child,” she says, “(paying them less) makes it impossible for them to live off that money.” This would “penalize families for choosing the best choice for them,” adds Stephanie Simcox, director of data management at the Children’s Council of San Francisco

• Paid less, because they don’t meet standards: “License-exempt is a fancy way of saying people who don’t meet the standards,” says Miller. “I personally don’t go to someone to treat me for (a medical problem) if that person has no background or license.” Fontenot adds, “Cuts should go to unlicensed providers. (If) they are doing it as a career...they should get licensed.”

Related issues and hot topics

• Chronic under-funding in the state’s child care licensing system: “Our licensing system has been really decimated in the last few years,” says Stromgren. “So until we (fix) that, it’s difficult to look at quality. We’re building a (quality) system on quicksand.” The legislature has begun an audit of the state’s child care licensing activities.

• Changes to how the state sets “regional” rates for subsidized child care: This year, the state used zip codes to determine how much providers are paid, rather than counties, as it has done in the past. Early care and education providers protested, saying this was unfair to providers in lower-income neighborhoods. The state stopped implementing the new rates and is figuring out a new plan.

• SB 908 (Kuehl) on child care: this bill will address reimbursement rates and other aspects of the child care system, though specifics are not decided yet.

For more information, contact the California Child Care Resource and Referral Network, 415-882-0234; www.rrnetwork.org or the Child Care Law Center, 415-394-7144; www.childcarelaw.org

What’s “quality” child care?

Advocates note many factors contribute to quality care:

• Education: “Child development classes help you set up an age-appropriate curriculum. The more education you have...the more insight you have into child development,” says Fontenot.

• Culture is important: “Any type of quality measure (should) include cultural quality,” says Strohl. Child care should honor the culture of the child and family.

• Different ideas about quality: “It’s very subjective, what constitutes quality for a parent,” says Stewart.

The National Association for the Education of Young Children offers a list of what parents can look for in a quality child care program:

• Children are generally comfortable, relaxed, happy, and involved in play or activities.
• All groups have at least two teachers.
• Teachers have specialized training in child development and early education.
• All areas of child’s development are stressed equally, including learning, physical skills, and social and emotional development.
• Staff meet regularly to plan and evaluate the program.
• Parents are welcome to observe, discuss policies, and participate.

The complete list is online at: www.naeyc.org

Extra resources from the Children’s Advocate bulletin

• Coaching for Quality in Infant-Toddler Care provides information about quality early care, as well as tools for strengthening responsive caregiving and connecting with parents. $60. Zero to Three, (800) 899-4301, summary online at http://www.zerotothree.org/bookstore
  pubDetails.cfm?pubID=2591
  
  
• Going to Scale with High-Quality Early Education, from RAND Corporation, describes how eight states are providing high-quality universal preschool. Topics include funding, access, accountability, staffing, and the unintended effects of policy choices on children, families, and communities. Online at http://www.rand.org/pubs/
  technical_reports/TR237/index.html
  
  
• In Our Own Backyards: Local and State Strategies to Improve the Quality of Family Child Care identifies key needs and strategies for improving quality in family child care settings. $25. summary online at http://www.iwpr.org/store/
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• Who’s Teaching Our Youngest Students?, from the National Institute for Early Education Research, finds that 85% of teachers in state-funded preschool programs earn salaries at or below “low-income” levels and that 19% work a second job to make ends meet. Includes state-specific data. Online at http://nieer.org/resources/ files/NPSteachers.pdf

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