Who’s Watching the Kids?

Why you should give a damn about this nation’s child care crisis.

Let’s face it. Child care in this country is widely regarded as the ultimate “women’s issue” Unless you are a working mother—or the comparatively rare single dad—the pathetic state of U.S. day care probably ranks near bottom on your list of things to fret about, somewhere between the perils of car phones and the skyrocketing cost of cable. Such ambivalence is hardly surprising. Americans have long viewed day care, with a certain degree of guilt and distaste, primarily as a service that allows parents to work. So long as the rest of us don’t have to hear too many horror stories about infants being molested by deviant caregivers or toddlers getting locked in a center after hours (as happened in suburban Virginia this year), we are content to leave this particular crusade to the mommies and daddies.

But increasingly, scientific research is highlighting the folly of this attitude. In April, the National Institute of Child Health and Human Development released a report showing that top-notch day care can enhance a child’s cognitive and language development, reduce behavior problems, and increase overall school readiness. In other words, we should regard day care as an educational opportunity for kids—not as baby-sitting. Even more compelling, in the spring of 1997 the Families and Work Institute released a study confirming that the first three years of life are the most critical in a child’s brain development, adding heft to a 1994 Carnegie report that showed much the same thing. Left alone to stare at the bars of her crib, an infant will not receive the stimulation necessary to form the neural pathways that guide later learning. Tended only when there is a nose to be wiped or a diaper to be changed, a toddler won’t develop the self-assurance to explore his place in the world. Kindergarten is too late. Unless a child receives individual attention and stimulation early on, by the age of three she has already fallen behind. The window has been closed. 

Now, consider these findings in light of the changing demographics of American society: An estimated 70 percent of moms now work outside the home, meaning more and more infants and toddlers are being looked after by relatives, friends, and professional caregivers. And in the wake of the 1996 welfare reform, tens of thousands more parents are being herded into the workplace, leaving tens of thousands more tots in need of care. Never has the case for affordable, high-quality child care been clearer—or the need greater. 

Unfortunately, this country’s day care situation (it’s much too slipshod to be called a system) borders on the criminal. Costs are high, too many providers are unqualified, health and safety standards are uneven, and educational opportunities are woefully wasted. While news accounts of toddlers wandering away from centers and babies playing with cockroaches are not the norm, they are indicative of a widespread problem. A 1995 national study found day care in six out of seven centers to be mediocre to poor, with one in eight potentially compromising children’s safety and health. The news for our youngest children was particularly grim: In 40 percent of classrooms serving infants and toddlers, children’s health, safety, and development were being compromised. Similarly, a 1994 survey found that the environment in a third of home-based care facilities was jeopardizing children’s development. 

Hillary Clinton tells a story: During one of her visits to France, which has what well may be the world’s best day care system, the First Lady asked a French official why the government had chosen to invest so much money in child care. His response: “How could we not? These are the future citizens of France.” 

Americans just can’t seem to grasp this point. Day care is not a “women’s issue”—or even a parents’ issue. The cliché about our having a choice between investing in children’s well-being when they’re young, or paying for the cost of their prison stays or welfare checks (or their not being able to vote intelligently) when they’re older is not much of an exaggeration. Every member of a democracy has a stake in how its citizens are being raised and educated. 

What’s more, considering the widening gap between the haves and have-nots in our society, particular attention must be paid to the plight of lower income children, who, research shows, suffer the most from poor-quality care. In addition to being in generally poorer health than middle-class kids, low-income children enter school facing significant learning disadvantages. The Children’s Defense Fund (CDF) reports that, while middle-class children starting first grade have been exposed to 1,000 to 1,700 hours of one-on-one reading, their classmates from low-income homes have been exposed to only 25 hours. In addition, CDF notes that low-income kids start school with half the vocabulary of middle-class students. A variety of studies have found that these “at risk” kids benefit more from high-quality child care and early education than children overall. But low-income families are the very ones shut-out of good programs. 

Indeed, even substandard care is prohibitively expensive for many families. With child care “tuition” averaging $3,800 a year, program costs are daunting for low- and moderate-income working parents, much less those struggling to get off welfare. A 1995 report by the Census Bureau showed that families earning less than $14,400 a year spend 25 percent of their income on day care. And the younger the child, the higher the costs. Government subsidies are available for our most impoverished citizens—but only for a fraction of those in need. Of the estimated 10 million families eligible for federal aid, only 1 million are currently receiving help through the Child Care and Development Block Grant program, with another 800,000 served by Head Start. Last year, New Jersey had around 15,000 children on its waiting list for subsidies; Florida had 21,000; Texas, 37,000; and so on. As recently as 1994, families in Clinton’s home state of Arkansas typically spent two years on a waiting list before receiving help. 

Paradoxically, even with the high costs and shortage of child care, caregivers are among the most underpaid professionals in the nation, earning an average $6.70 an hour—less than the average parking attendant or car wash employee. (Americans do love their cars.) As a result, dedicated, qualified caregivers are tough to find, and even tougher to hold onto: Staff turnover averages 33 percent a year. 

To their credit, some political leaders have vowed to address the problem. Last October, the National Governors’ Association (NGA) held a conference to explore ways to give young. children “the best possible start in life.” The National Conference of State Legislators is also studying the issue, and state expenditures in early child development are on the rise according to a fiscal survey released in December by the NGA. On the federal level, the First Lady has adopted child care as her pet cause, and in October she and the president hosted a White House conference on the issue. Three months later, Clinton unveiled a proposal that would provide nearly $22 billion over the next five years to improve child care, with $3 billion set aside to aid children five and under. Not to be outdone, several members of Congress have rushed to introduce their own plans. 

Political bickering, however, may yet sink the reform boat. Legislation to reauthorize (i.e., continue funding for) Head Start remains tied up in Congress, as do the various proposals to increase funding for the child care block grant. The president was hoping to finance a chunk of his day care package (elements of which are contained in bills before Congress) with income from the tobacco bill. But Republicans effectively killed the bill in June, and even if it’s revived in a weaker form, how much money will ultimately go toward child care remains uncertain. Social conservatives, miffed that we can’t return to the days when Mommy stayed home with the kids, complain that government-subsidized care is an insult to stay-at-home mothers, and are lobbying instead for more tax breaks. (Though this would hardly help the neediest families.) Then, of course, there are the perennial big government bashers. Case in point: Just before the tobacco bill’s untimely demise, the Kerry-Bond amendment earmarking part of the funds for child care passed the Senate on a 66-33 vote. Sen. Phil Gramm, however, promptly pledged to introduce an amendment that would strip Kerry-Bond from the bill, leaving states to use tobacco funds any way they saw fit. 

And while the politicians bicker and drag their feet, millions of children are wasting their days—and their potential — in unfit facilities. 

A Thankless Job 

There’s a growing consensus among child development experts that what matters most in day care for infants and toddlers is the children’s relationships with caregivers. “In these early years, children learn about themselves and the world, their identity, what to value, and what not to value through their interaction with a few caring adults,” explains Abbey Griffin, director of the nonprofit group Zero to Three. 

But despite our society’s grand pronouncements about valuing children, U.S. day care workers are treated like second-class citizens. “The pay,” sighs Griffin, “is enough to make your stomach hurt.” A 1988 study by the Center for the Child Care Work Force found that “child care teaching staff earned less than half as much as comparably educated women and less than one-third as much as comparably educated men in the civilian labor force.” Between 1977 and 1988, staff wages (adjusted for inflation) fell more than 20 percent. The situation was so pathetic, notes the center, that when California launched its GAIN welfare-to-work program in 1985, many counties discouraged or excluded child care as a career option for welfare recipients, because the low pay made the profession an unlikely route out of poverty. What progress since then? In a 1997 update, the center reported that real wages for caregivers have remained essentially unchanged since ’88. (The rising economic tide, it seems, has failed to lift this particular boat.) Teachers typically earn between $13,000 and $19,000, while teaching assistants average between $10,500 and $12,250 a year. (Compare this to France, where caregivers’ pay is in line with that of elementary school teachers.) The benefits situation is equally dismal. In a separate 1997 report, the center noted that fewer than one-third of day care centers provide health insurance, and even fewer offer a pension plan. Home-based care providers, of course, are on their own. 

Perhaps nowhere is Americans’ failure to grasp the importance of early child care more visible. While we recognize the value of recruiting qualified teachers for school age kids, the unspoken belief seems to be that since any idiot can have a child, by extension, any idiot can take care of one. According to the Center for Career Development in Early Care and Education, 39 states and the District of Columbia do not require prior training for home-based caregivers; 32 states don’t require prior training for teachers in centers. “For a long, long time people have taken early parenting and child care as just baby-sitting,” says Griffin. “Whatever you do to keep them warm and fed and safe is OK. Well, we have concrete evidence now that it’s not OK.”

Certainly, not every caregiver needs a Ph.D. in child development. But research shows that better trained providers mean better care, and caregivers without formal training should get instruction in the basics of first aid, health and safety practices, and so on. 

Nonetheless, the “any warm body will do” attitude remains evident as states, pushing to meet the welfare roll reductions dictated by the ’96 reforms, try to kill two birds with one stone by transforming welfare moms into caregivers. Wisconsin, for instance, has created a category of “provisionally certified” care that allows an adult with absolutely no training to provide care in her home for up to three children. What’s more, the state will give parents receiving child-care subsidies a 30 percent discount on their co-payments for using a provisionally certified provider rather than a licensed caregiver. Minnesota passed legislation allowing unlicensed providers to care for as many as five children at home, and Michigan lowered the minimum age requirement for at-home caregivers to 16. Such incentives seem to confirm child-care professionals’ fears that, in the rush to find affordable care options, states will further sacrifice quality. 

Although many welfare moms may turn out to be fine caregivers, says Griffin, “if you don’t provide training and screening and career counseling, you get a kind of one-third, one-third, one-third effect: One-third of the people have an interest in child care and may go on to get training. One-third are good with babies and could be OK, but are likely to go on to a better-paying job like bagging groceries or being a parking attendant as soon as the opportunity comes along. And one-third really need to be counseled to get out of child care because they are not interested in it and will not be good for the children.” 

Considering the profession’s sorry wages and haphazard approach to recruitment, it’s hardly surprising that the child-care workforce looks like an advertisement for the politically disenfranchised: Ninety-eight percent of caregivers are female; one-third are women of color; many are living at or below the poverty level. More than one-third of day care centers employ welfare mothers receiving Temporary Assistance for Needy Families payments. Most people with the skills, means, or education to find better-paying employment do. Economic upturns like the one we’re now experiencing only speed the exodus. With other businesses hungry to hire, it doesn’t take long for a minimum-wage child care provider with little vested in her job to find greener pastures. This constant parade of caregivers, say experts, is detrimental to infants and toddlers, disrupting their sense of security and confidence. It’s also a serious waste of money, since centers must constantly locate and break in new people. 

North Carolina thinks it has a partial solution to the problem. Through its TEACH Early Childhood Project, the state has established a system that offers child care providers scholarship money to pursue child care training or child development degrees. Those who pursue additional education receive bonuses or wage increases. Started as a pilot project in 1990, more than 7,000 providers have since enrolled—with 4,000 scholarships granted just in the past year. On average, participants complete 18 credit hours per year and receive a 10 percent increase in wages. The state, in turn, winds up with a better trained, more committed workforce: TEACH participants have a less than 10 percent turnover rate, compared to 42 percent statewide. But here’s the kicker: The program largely pays for itself. Thanks to increased staff retention, says Sue Russell, the state’s executive director of day care, less time and money are lost to recruiting and orientation, offsetting most of the program costs. 

North Carolinians aren’t the only folks aware of the benefits of linking training to compensation. This practice has become standard operating procedure in what is widely considered the guiding light of US day care: the Defense Department’s child development program. The military’s approach to basic caregiver training is simple, says Linda Smith, head of the department’s Office of Family Policy: “If you complete it, you stay. If you don’t, you’re fired.” Before a caregiver begins working with children, he or she undergoes an orientation addressing everything from CPR to recognizing the signs of child abuse. Once on the job, the caregiver continues through a comprehensive training program. On average, the process takes about two years to complete. But as people move through the system, explains Smith, they also move up the pay scale. 

Such programs have not gone unnoticed by the Clinton administration. North Carolina Gov. James Hunt was invited to speak at the White House conference on child care, and the DoD has been asked to share “lessons learned” about high-quality care with civilian providers. What’s more, the president’s child care proposal includes $250 million for a Child Care Provider Scholarship Fund based on the TEACH and DoD models. Similar to North Carolina’s program, scholarship recipients would commit to one year of continued service for every year of assistance received, then earn salary increases or bonuses as they completed their course work. 

Even Standards Are Substandard

Caregiver training isn’t the only area of day care where standards need to be upgraded. A 1997 report by Yale University found that U.S. child care is, to quote a press release on the study, “overwhelmingly mediocre or poor in every state, thus posing a threat to children’s development, mostly because state legislators are setting standards far too low.” (There are no national standards.) Many states don’t regulate the number of infants or toddlers in a class, and many disregard recommended adult-to-child ratios. Although the National Association for the Education of Young Children recommends a ratio of one adult for every four children under nine months old, 20 states allow providers to exceed that limit. (Idaho allows one adult for every 12 infants.) Thirty-five states exceed the preferred ratio of one adult for every six two-year-olds. 

For its part, the federal government has no intention of assuming the role of enforcer. The Department of Health and Human Services, which oversees the child-care subsidies program, serves as little more than a bank. Federal aid—around $3 billion a year—flows from HHS to the states via the Child Care and Development Block Grant. State (or county) social service agencies in turn distribute around 70 percent of the money to needy families in the form of vouchers. (The rest goes directly to centers or toward improving the quality of existing care.) Vouchers may be used in any type of care environment: home-based provider, relative, friend, center. The benefit is that each parent can arrange for the child-care situation that best fits his or her needs. The obvious downside is that lower income parents don’t always have a lot of options, particularly since providers can refuse to accept vouchers. And since neither the federal government nor the majority of states place serious quality restrictions on who can receive vouchers, children often wind up in unsound, or even unsafe, environments. “The problems come when there isn’t much availability in an area or when the choices are substandard and parents are forced to leave their kids with someone who’ll plop them in front of the television all day,” says HHS spokesman Michael Kharfen. 

HHS places few regulatory demands on states receiving grant money. For instance, states must provide matching funds, limit assistance to families with incomes below 85 percent of the state’s median income (or lower, if the state so chooses), and establish minimum health and safety protections for programs that receive funds. What these protections should be and how they are enforced, however, is up to the states. “[The federal government’s role] is not about setting rules,” says Kharfen. “It is not about prescribing how programs should be.” Such hands-off rhetoric may sound enlightened in the current devolutionary political climate, but if the federal government is going to dole out several billion a year in child-care subsidies, it absolutely has a responsibility to see that taxpayers are getting their money’s worth. 

The government’s Early Head Start program is somewhat better regulated. Early Head Start, which offers prenatal care to expectant mothers and care to children ages zero to three, was created in 1994 as an outgrowth of the main Head Start program, which serves mainly 3- and 4-year-olds. Launched in 1965 as part of Lyndon Johnson’s War on Poverty, Head Start aims to level the playing field by giving children living at or below the poverty line an introduction to the health, socialization, and education basics they might not be learning at home. The program takes a comprehensive approach to care: It ensures that kids receive their vaccinations, instructs them in the fundamentals of nutrition and hygiene, teaches them about sharing and interacting with others, and, of course, tries to get them interested in learning. 

Like the main Head Start program, Early Head Start is funded directly by the federal government and is subject to federal standards. These standards, recently upgraded for 1998, not only regulate basics such as adult-to-child ratios and group sizes, but also set guidelines for everything from the number of square feet of indoor space required per child to the nutritional content of children’s meals. Twenty-five percent of any funding increase must go toward program improvement, and at least 2 percent of all funds go toward teacher training. 

Establishing quality standards, however, is largely pointless if no one enforces them. Even after passing several initiatives aimed at improving and enforcing standards, Head Start is still widely criticized for the uneven quality of its programs. Centers are inspected only once every three years, allowing serious problems to fester in the interim. For instance, a 1993 report by the HHS Inspector General’s office showed that only 54 percent of Head Start kids had received proper medical screening. Then there are the grisly anecdotes, such as the Brooklyn program that was shut down only after the city controller, having received complaints about the center, discovered “dangerous and disgusting” conditions in its kitchen. The situation with state-regulated care is equally problematic. Many agencies aren’t given the resources to enforce what meager standards states have in place. More than half the centers in Washington, D.C., for example, are operating with expired licenses. 

Here again, the Defense Department shows what can be done with adequate support and investment. Regular inspections are a central part of what makes the military’s program successful, says Linda Smith. “I credit our quality to the enforcement of our standards, not the standards themselves,” she asserts. “The military is often accused of being a Cadillac program, but in reality our standards meet the middle of the road for states. In adult-to-child ratios, in group sizes—we’re right there in the middle.”

Child care providers for the military—whether in centers or at home—are subject to unannounced quarterly visits by a combination of fire, health, safety, and program inspectors. (Smaller-scale inspections occur more frequently.) Providers found to be in serious violation of standards can have their licenses suspended or revoked. For more minor infractions, written or verbal warnings may be issued. The secret, says Smith, is that the inspections are unannounced. “As a provider, if you know an inspector is coming, you can fix anything. When I worked in [private] day care, I always knew when they were coming. If I was violating ratios, I just wouldn’t have some kids there that day.” To prevent such manipulations, the military takes the surprise nature of its visits very seriously: “I have taken teams from this office to Sicily to Japan to Germany and shown up on a provider’s doorstep and they did not know we were coming.” And although they’re infinitely more effective, notes Smith, unannounced inspections don’t cost a dime more than prearranged ones. 

Another benefit of the military’s inspection system is that it is multi-tiered. Rather than one agency handling all inspections, visits are alternately conducted by representatives at the individual base level, the major command level (groups of bases with similar functions), the headquarters level (Army, Navy, Air Force, etc.), and on occasion the Office of the Secretary. If, say, representatives from Navy headquarters discover that day care providers at a base, or a group of bases, are being inadequately monitored, steps can be taken to deal with both the providers and their lax inspectors. This practice of overseeing the overseers prevents breakdowns in the system from going unnoticed. 

Time to Get Serious

While child care experts and advocates talk about the importance of good caregivers and high program standards, they all stress that more money must be made available to extend these benefits to more families. “The bottom line is that we need more resources,” says Gina Adams of the CDF. “The big challenge with child care isn’t that we don’t know what to do, it’s that we don’t have the resources to bring the programs that are working up to scale so that they are helping all kids.” 

Currently, the Head Start and block grant programs combined serve fewer than 2 million kids. This covers roughly one-third of those eligible for Head Start, and a tenth of those eligible for the less-restrictive block grant. Even were Clinton’s $22 billion proposal to become a reality, the number of children served would rise to just over 3 million. By the government’s own estimates this would still leave some 7 million kids without help. What’s more, the vast majority of Head Start programs last only a half day and don’t run during the summer months. Expanding all programs to run all day, all year would increase funding needs dramatically. “They think they’re doing us a giant favor with that $22 billion,” says Abbey Griffin. “But that money is just a drop in the ol’ bucket.”

If Americans are serious about giving every child the best possible start in life, we must reframe how we view—and fund—child care. Currently, we’re approaching the problem from the wrong end: heavily subsidizing public schools and state universities, yet failing to invest in the earliest, most vital years of a child’s development. As the National Governors’ Association noted in its December survey: “[T]he capacity to acquire knowledge, skills, and appropriate development for school-age children is largely diminished without enriching experiences between birth and age three.” This suggests we should get at least as serious about funding early child care as we have been about later schooling. “Public education couldn’t do it without tax money,” notes Mary Whitebook of the Center for the Child Care Workforce. “This is true in child care as well, we just don’t see it as a social good.”

The president’s proposal would be a fine place to start. In addition to increasing funding for Head Start, the block grant, and teacher training, it includes tax breaks for private businesses that invest in child care programs for employees. This type of private-sector involvement will be key in getting day care the financial support it deserves, but it does not absolve the government from taking further steps to address the crisis. This nation makes clear what it values by how it allocates public funds. On the state level, investment in child care is far outpaced by spending on corrections and roads. (The CDF notes, for example, that in 1994 Mississippi spent 78 times more on corrections than on child care, and 423 times more on highways.) On the federal level, while the president’s $44 billion a year plan is nothing to sneeze at, keep in mind that the oil industry receives an estimated $5 billion in annual subsidies and Congress is considering giving tobacco farmers an $18 billion buyout in exchange for ending the long-running tobacco subsidies program. Giving our children a healthy start is surely as important as shoring up any particular corporate interest. Moreover, if we are prepared, as Clinton has proposed, to put this year’s $43-$63 billion budget surplus toward shoring up Social Security for seniors, we can damn well find a way to make an equivalent investment in our children. As President Clinton put it: “We’ll never be the kind of country we ought to be unless we believe that every child counts and that every child ought to have a chance to make the most of his or her God-given abilities.”

Until we start thinking this way—recognizing that providing every family access to high-quality day care is an investment in our future, not some bleeding-heart social program—every minor political disagreement to come down the pipeline will be enough to derail real reform. 

Let’s just hope Congress remembers this as it sits around squabbling about how to spend the growing budget surplus.

Research assistance provided by Seth Grossman.

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Michelle Cottle

Michelle Cottle is a member of the New York Times editorial board and the Washington Monthly's Board of Directors. She was an editor for the Monthly from 1996 to 1998.