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The current study is a qualitative investigation of stakeholders’ perceptions of issues that surround access to quality early childhood care in rural Midwest communities. By exploring the perceptions and understandings of stakeholders who are currently engaged in the childcare system, a different and important viewpoint with local knowledge is foregrounded. This study employed qualitative focus groups, interviews and open-ended surveys. The study was carried out in partnership between the university and community organizations. Findings illuminate the complicated relationship between access and quality, the different ways stakeholders defined financial issues, and a highlighting of the need for mental health and behavioral training for early childhood professionals. Expanded university-community multidisciplinary partnerships could be a key approach to addressing issues in under-resourced communities.