How Do State Subsidy Policies Affect Child Care Access for Families of Children with Disabilities?

• In Event: Supporting Access to Quality Child Care: Subsidy Policy, Providers, and Underserved Families

Abstract

Families of children with disabilities often experience barriers to accessing affordable and appropriate care for their children, affecting children’s development and parental employment. These families disproportionately live with low incomes, further limiting their child care access. Child care subsidies funded by the Child Care Development Fund (CCDF) play a crucial role in addressing unequal child care access for these families. The CCDF Final Rule identifies children with disabilities as a priority population and outlines policy approaches states can adopt to support equitable access for these children. However, the literature on the effectiveness of these policies is limited. The current study examines two specific policies: 1) prioritizing/guaranteeing subsidies for eligible children with disabilities; and 2) differential provider reimbursement rates for caring for children with disabilities. The study aims to examine the relationships between these CCDF policies and child care outcomes—use of paid care, use of full-time paid care, and the weekly cost—for children with disabilities.

The study uses data from the National Survey of Early and Education (NSECE) merged with the CCDF Policies Database from 2012 and 2019. The sample consists of 23,067 children under age 13 from low-income families (i.e., household income below 200% of the federal poverty level); 10.5% of the sample have a disability (i.e., having a physical, emotional, developmental, or behavioral condition that affects the way care is provided). We use difference-in-difference-in-differences (DDD) to estimate the effects of the key CCDF policies on child care outcomes for low-income children with disabilities. We also conduct multiple regression to assess the associations between the focal CCDF policies and child care outcomes and whether the associations vary by disability status. All analyses account for child, household, and state characteristics. We separate analysis by child age (0-5 years and school-age) when the sample size permits. We engage with families of children with disabilities who use child care subsidies and with Child Care Resource and Referral professionals who support these families to contextualize the findings within families’ lived experiences.

Overall, the percentages of children in paid care and full-time paid care were similar between children with and without disabilities, with one exception. A higher percentage of children under 5 with disabilities (41%) were in paid care than those without disabilities (30%). There was no significant difference in the average weekly care costs by disability status. Results suggest that children with disabilities were more likely to be in paid care than their counterparts, and the gap was more pronounced for children under 5. We did not find causal relationships between the focal CCDF policies and any of the outcomes from the DDD models. Descriptive analyses indicate that differential reimbursement rates were associated with an increased likelihood of using paid care for all children (by 6.7 percentage points) and lower weekly costs for school-aged children with disabilities (by $30.20).

As states consider how to best improve child care access for children with disabilities, findings from the current study provide insights into how CCDF policies can contribute to this effort.

Author

• Ying-Chun Lin, Child Trends, Inc
  Presenting Author