Expanding ECE Access for Infants and Toddlers: Provider Perspectives on Nevada’s Infant-Toddler Contracted Slots Program

• In Event: Infant-Toddler Child Care Amidst Changing Policy Landscapes: Family Preferences, Preschool Expansion, and Provider Perspectives

Abstract

Introduction

Access to high-quality early care and education (ECE) for infants and toddlers remains a persistent challenge across the United States, particularly for low-income families, and especially in Nevada (Children’s Cabinet, 2022). Relying on COVID relief funds, Nevada is among several states that implemented an Infant Toddler Contracted Slots (ITCS) policy program aimed at significantly expanding access to subsidized care for eligible infants and toddlers. The policy initiative increased reimbursement rates to providers to approximate the true cost of care for infants and toddlers, while also ensuring low or no costs for families.

Purpose

Despite the promise of ITCS programs, limited research has examined how ECE providers make enrollment decisions under such programs, particularly within the context of multidimensional access (Friese et al., 2017). This study addresses that gap by focusing on the experiences during the implementation of Nevada’s ITCS program.

The study was guided by the following research question:

●      How do Nevada’s ECE providers make decisions about enrolling infants and toddlers when participating in the ITCS program?

Methods

We conducted a qualitative study of 30 licensed ECE providers who participated in Nevada’s ITCS pilot program. Purposeful sampling was used to capture variation in provider type and geographical location throughout the state. In-depth semi-structured interviews explored how providers navigated decisions about enrolling and prioritizing infants and toddlers through the ITCS program. Data were analyzed using a reflexive thematic analysis approach (Braun & Clarke, 2022), beginning with inductive coding to identify initial categories from provider interviews. We used the constant comparative method (Saldaña, 2021) to refine codes and develop emergent themes. To further interpret the data, we applied the ECE access framework (Friese et al., 2017), which conceptualizes access across four interrelated dimensions: affordability, reasonable effort, support for child development, and meeting family needs. We drew specifically on pre-ordinate themes related to these dimensions (Proudfoot, 2023).

Results

Our findings revealed that providers discussed access along three dimensions. Under Reasonable Effort, providers shared how ITCS participation facilitated the enrollment and prioritization of infants and toddlers by offering predictable funding and incentivizing full-time care. However, many providers also cited limitations in enrollment capacity due to space limitations that restricted their ability to fully utilize ITCS slots. In terms of Affordability, providers reported that the program reduced financial burdens for families and improved financial predictability for programs. At the same time, concerns emerged about sustaining affordability and enrollment once ITCS funding sunsets, with providers anticipating tuition increases or needing to seek alternative subsidies. Finally, regarding Support for Child Development, providers highlighted improvements in program quality, specifically relating to lower classroom ratios. Relatedly, professional development opportunities and increased staff retention were made possible through ITCS participation.

Conclusion

This study contributes new insights into how providers navigate complex enrollment decisions within state-level contracted slot initiatives. By applying a multidimensional access framework, the findings elucidate both the affordances and limitations of ITCS programs as experienced by ECE providers. These insights can inform future policy design-related decisions to sustain and scale equitable access to infant and toddler care.

Authors

• Alain Bengochea, University of Nevada - Las Vegas
  Presenting Author

• Gerilyn Slicker, University of Nevada - Las Vegas
  Non-Presenting Co-Author