This report focuses on the financial aspects of child care from the perspective of families and government. The need for affordable child care in the Southern states is illustrated in a series of state-by-state charts and graphs. Information on the percentage of low-income families that receive help paying for child care in each state is also…
Changing family dynamics over the past four decades, including rises in the numbers of working mothers and single-parent families, have created an increased need for affordable child care. Government response to this need has involved a number of stop-and-start policy approaches, which have led to a fractured child care system that makes it…
Southern Inst. on Children and Families, Columbia, SC.
The Southern Regional Initiative on Child Care (established by the Southern Institute on Children and Families) is guided by the Southern Regional Task Force on Child Care including representatives from 16 southern states and the District of Columbia. The initial charge from the Task Force was to develop a southern regional action plan to improve…
Payson, Norman C
Not all plans are jumping headlong into the consumer-centric arena. In this article, the CEO of Oxford Health Plans discusses how advanced managed care can achieve what other consumer-centric programs seek to do--provide affordable, quality health care. PMID:12391815
Rak, Sofija; Coffin, Janis
The Patient Protection and Affordable Care Act of 2010 (PPACA), although a subject of much debate in the Unites States, was enacted on March 23, 2010, and upheld by the Supreme Court on June 28, 2012. This act advocates that "healthcare is a right, not a privilege." The main goals of PPACA are to minimize the number of uninsured Americans and make healthcare available to everyone at an affordable price. The Congressional Budget Office has determined that 94% of Americans will have healthcare coverage while staying under the $900 billion limit that President Barack Obama established by bending the healthcare cost curve and reducing the deficit over the next 10 years. PMID:23767130
... go to the caregiver's home. Finally, there are child care centers. You need to choose the one that works for your family. It is important to get to know your child's caregivers. They will be a big part of ...
McClelland, Mark; Asplin, Brent; Epstein, Stephen K; Kocher, Keith Eric; Pilgrim, Randy; Pines, Jesse; Rabin, Elaine Judith; Rathlev, Niels Kumar
The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage. Discussions between EDs and primary care physicians about their respective roles providing acute unscheduled care would promote the goals of the ACA. PMID:25121814
Working for Change, 1995
Part of a series from the Child Care Law Center, this issue of "Working for Change" discusses the need for quality, affordable child care as a support for working parents trying to break out of welfare dependency. This report details the current realities of poor parents who struggle to find and pay for child care while they work and those who…
Lowe, Paula C.
Those responsible for the care of another human being, such as a child, an elderly parent, or an ailing spouse, often need help and support. Carepooling is the act of caregivers exchanging day-to-day help and support. This book offers simple, effective, practical ways to exchange help and share support with friends, neighbors, and co-workers.…
Campbell, Wendell, Comp.
The St. Louis (Missouri) Regional Child Care Partnership was created in 1990 to improve child care in the St. Louis and Metro East areas, where the quality, availability, and affordability of child care are community-wide problems. The partnership was formed by the Child Day Care Association of St. Louis and the St. Louis branches of the Junior…
Traill, Saskia; Brown, Brentt
The child care industry has not been fully integrated into economic development activities despite its growing importance in the economy. This is, in large part, because child care is not usually thought of as an element of economic development. As a result, states in the North Central region are not maximizing the economic benefits from quality,…
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Issar, Neil M; Jahangir, A Alex
The Affordable Care Act has resulted in a dramatic governmental restructuring of the healthcare insurance market and delivery system. Orthopaedic traumatologists must be aware of the law's impact on their clinical practice, finances, and overall business model. This includes the effect of accountable care organizations, the Independent Payment Advisory Board, and the Physician Value-Based Payment Modifier program, as well as the impact of the Affordable Care Act's grace period provision, medical device excise tax, and cuts to funding for the Disproportionate Share Hospital program. PMID:25229683
Children's healthy development depends on safe and positive experiences when they are very young. If you work or go to school, you want to know that your child is in good hands while you are away. You may ...
Schade, David S.
Abstract The Affordable Care Act—“Obamacare”—is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different “metallic” insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care. PMID:24927108
The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…
This report examines a basic child care challenge confronting the state of Texas: the shortage of affordable, accessible, quality early care and education for Texas families with children, particularly those with limited incomes. The report notes that these three factors--affordability, accessibility, and good quality--are integral to a successful…
Gormley, William T., Jr.
In the face of social changes that are increasing the demand for available, affordable, quality child care, it is difficult to continue to think of child care as a purely private issue. This book presents an analysis of the state of American child care. It evaluates child care policies and the national attention given to young children and their…
... people Unemployed people Immigrants Taxes, Penalties & Exemptions Health care & taxes The penalty for not having coverage Exemptions ... in the SHOP Marketplace The Small Business Health Care Tax Credit Renew or change SHOP coverage How ...
Rep. Rangel, Charles B. [D-NY-15
03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:
Shi, Qian; Nellans, Frank P; Shi, Lizheng
The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population. PMID:26458377
Child Care, Inc., 2012
Like all difficult decisions, choosing child care can seem overwhelming, and this is particularly true when choosing care for children under three. The better you understand what your child's and your own personal needs are, and what is available and affordable to you, the more confident you will become in your decision-making process. This…
... GetCovered: My Story State by State Widgets & Badges Preventive Care for Children Many insurers are now required ... for mothers and vaccinations for kids. 26 Covered Preventive Services for Children Alcohol and Drug Use assessments ...
McGhee, Marilyn, Ed.
This document is comprised of six issues of the Child Care Bulletin, a bimonthly publication of the National Child Care Information Center. The January-February issue focuses on involving communities in child care planning. Topics discussed in this issue include: community mobilization strategies, assessing needs and establishing goals, and…
Olds, Anita Rui
This book provides architects, interior designers, developers, and child-care professionals with detailed information on the planning and design of child care centers. Part 1 examines the current state of child care in the United States and offers an overall philosophical concert--the spirit of place--as the framework for all center design. Part 2…
Levy, Vic; And Others
This paper provides information on child care needs, existing services, and special topics related to child care in Dane County, Wisconsin. Section I describes and compares needs and services; indicates locations of current full-day services; and offers specific recommendations for expanding child care. Section II concerns cost and affordability…
Williams, Stephen L; Nichols, Beverly L; Barton, M Katherine; De LaCruz, Maria; Hernandez, Benjamin
Local health departments are in key positions to lead in the education and implementation efforts to advance the Patient Protection and Affordable Care Act. The first enrollment period is over, but the efforts to enroll the uninsured and advocate for expansion of Medicaid in the states that have not yet taken on this expansion will continue for years to come. Political climates may be unsupportive, but some actions may still be possible. PMID:25423062
Mitchell, Anne; Gage, Diane
This special issue on child care presents articles on children's health, day care, grandparents, father-child relationships, pregnancy after age 40, children's dental care, children's moral development, parties for children, children's fighting, fashions in children's clothes, sibling relationships, and health care programs for children. (BC)
How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding. However, a recent analysis in California has found that the costs of expanding state-supported care to include undocumented immigrants would largely be offset by the increased state sales tax revenue paid by managed care organizations and by reduced spending at the county level on emergency-room and hospital care of the uninsured. PMID:25231664
... 2014 OCC has a variety of resources and tools related to the law. Visit our Reauthorization site to find webinars, program instructions, and other guidance and information. > What is the Office of Child Care (OCC)? The Office of Child ...
Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice
Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding. PMID:26318941
Nyman, John A; Trenz, Helen M
Central to the Affordable Care Act is the notion of affordability and the role of health insurance in making otherwise unaffordable health care affordable. We used data from the 1996 to 2008 versions of the Medical Expenditure Panel Survey to estimate the portion of overall health care expenditures by insured respondents that would otherwise have been beyond their disposable incomes and assets. We found that about one third of insured expenditures would have been unaffordable, with a much higher percentage among publicly insured individuals. This result suggests that one of the main functions of insurance is to cover expenses that insured individuals would not otherwise be able to afford. PMID:26691116
In this article, the author describes early learning and care arrangements in Canada and how the country faced the challenges in the development of a National Child Care System. While the provincial/territorial governments are responsible for early learning and care, the federal government has formed health and social programs including some child…
Chase, Richard; Valorose, Jennifer
Nearly 500,000 households in Minnesota include a parent or parents with at least one child age 12 and under. About three-quarters use some type of child care. The strength of the economy depends on families having high-quality, affordable child care, so parents can work and children have the early learning opportunities they need to perform better…
These six fact sheets from Child Care Aware are designed to help parents ease their children's transition to child care. The first fact sheet, "Before Your Child's First Day," discusses tips such as: (1) "prepare your child"; (2) read and look at picture books about child care; and (3) "prepare yourself." The second fact sheet, "First Day Tips,"…
... for parents. Learn more about this project > EHS Expansion and EHS-CCP Funding Opportunity Announcements Posted Use ... Reporting Guide Latest from OCC Early Head Start Expansion and Early Head Start-Child Care Partnership Funding ...
Shore-Sheppard, Lara D
Objective To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Data Source Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Study Design Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138–250 percent FPL, 250–400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Data Collection/Extraction Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22–64 years. Principal Findings Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Conclusions Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. PMID:25327987
Phillips, Deborah; Lande, Jeff
Considers child care as a political issue and examines the positions of 1988 presidential candidates on child care. Discusses whether concern over the issue of child care is good politics and suggests that readers write to candidates and elicit their positions on child care. (RWB)
Congress of the U.S., Washington, DC. Senate Committee on Finance.
A publication releasing the most important current statistics, reports, statutory language, and regulations on child care is presented. Data are presented under the following general topics: (1) Child Care Services and Working Mothers, (2) Child Care Arrangements of Working Mothers Today, (3) Federal Assistance for Child Care, (4) How Much Does…
The author presents insights from various readers of "ExchangeEveryDay" regarding trends in the world of family child care. Kathleen Reticker of Acre Family Child Care in Lowell, Massachusetts thinks an increasing trend in Family Child Care is the pressure to emulate a Center, instead of seeing family child care as a different model. Over the…
Improving the Quality of Child Care. Hearing of the Committee on Labor and Human Resources on Examining Proposals To Improve the Quality of Child Care in the United States, Including the Proposed Creating Improved Delivery of Child Care: Affordable, Reliable, and Educational Act of 1997. United States Senate, One Hundred Fifth Congress. First Session.
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
These hearings transcripts present testimony on proposals to improve the quality of child care in the United States. Both oral and submitted written statements are included. Contributors are: Representative Peter Deutsch (Florida); Senator James M. Jeffords, committee chairman; Senator Mike Enzi (Wyoming); Senator Edward M. Kennedy…
Davis, Elizabeth E.; Krafft, Caroline; Tout, Kathryn
The Minnesota Child Care Assistance Program (CCAP) provides subsidies to help low-income families pay for child care while parents are working, looking for work, or attending school. The program can help make quality child care affordable and is intended both to support employment for low-income families and to support the development and…
Agenda for Children, 2006
The "2006 Agenda for Children Louisiana Kids Count Special Report on Child Care" documents and describes the supply and affordability of child care and early education in each of Louisiana's 64 parishes. Seventy-eight percent (78%) of Louisiana's children under the age of five are cared for by someone other than a parent or guardian on a regular…
Australian Dept. of Labour and National Service, Melbourne. Women's Bureau.
Based on a survey of legislation relating to full-day care for preschool children of working mothers and a study of records, this report: (1) covers the number of registered child care centers in Australia and the number of children being served, (2) sets the conditions applying to registration of centers, (3) indicates the extent and levels of…
Burchinal, Margaret; Howes, Carollee; Kontos, Susan
Used data from a family child care study and a licensing study to identify dimensions best predicting global day care quality in over 300 child care homes. Found that caregiver training most consistently predicted global quality. Found no reliable association between care quality and child-caregiver ratio or age-weighted group size recommendations…
Matthews, Hannah; Schmit, Stephanie
Child care subsidies help make quality child care affordable for low-income parents, allowing them to attend work or school to support their families while ensuring their children's healthy development. The Child Care and Development Block Grant (CCDBG) is the primary source of federal funding for child care subsidies for low-income working…
Matthews, Hannah; Schmit, Stephanie
Child care subsidies help make quality child care affordable for low-income parents, allowing them to attend work or school to support their families while ensuring their children's healthy development. Access to quality child care is also proven to strengthen families' economic security. The Child Care and Development Block Grant (CCDBG) is the…
Segal, Marilyn, Ed.; Manburg, Abbey, Ed.
This resource book for child care practitioners has been written for administrators, nursery school teachers and preschool or Head Start teachers who are interested in practical suggestions (1) for setting up classrooms, (2) for developing a curriculum for infants, toddlers and preschool children, (3) for meeting the social-emotional needs of…
Ghazvini, Alisa S.; Mullis, Ann K.; Mullis, Ronald L.; Park, Jennifer J.
Access to affordable, quality child care is a major barrier to successful employment for many families. About one-fifth of families return to welfare within a few months of leaving, with lack of accessible child care and transportation being the most frequently cited reasons. These issues are likely to be compounded in the rural South. Information…
This report documents the relationship between the supply of reliable, affordable, accessible child care and the health of Vermont's economy. The child care industry is a growing part of the Vermont economy, pumping money into local communities by supporting working families, creating jobs, and generating taxes through employment and the purchase…
Recent proposals by President Clinton to increase the availability and affordability of child care address a major issue of concern for many parents. This Harris Poll on child care surveyed 1,000 adults between January 14 and 18, 1998. The findings indicate that: (1) about half of all adults were aware of the president's recent proposal; (2) most…
Colorado State Dept. of Human Services, Denver. Div. of Child Care.
This report examines child care from a business perspective and proposes methods to help finance affordable, accessible, and high-quality child care in Colorado. The Commission's procedures are described, and data summaries are included. The following 12 recommendations are made: (1) establish model planning and zoning programs to increase and…
Mehnert, Barbara H., Ed.
As the number of working women with young children continues to grow, the demand for affordable, high quality child care increases as well. Existing licensed centers and family day care programs can only accommodate 2.5 million children, while 10.5 million children under the age of 6 have working mothers. The quality of child care programs has a…
Newton, Marion F., Ed.
This document is comprised of the three 1998 issues of a newsletter disseminating information on the National Coalition for Campus Child Care Centers (NCCCC) and providing a forum for news, research, and information concerning campus child care centers. The February issue contains stories on the White House Conference on Child Care, registration…
This fact sheet provides an array of statistical data on working mothers, such as the need for child care, the child care providers, who supports child care, and work and family. Data sources include a number of federal government and private organizations. Among the statistics highlighted are the following: (1) in 1988, 65 percent of all women…
Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.
This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…
California State Dept. of Education, Sacramento.
CALIFORNIA CHILD CARE CENTERS WERE ESTABLISHED IN 1943 TO SUPPLY SERVICES TO CHILDREN OF WORKING MOTHERS. THE CHILD CARE PROGRAM PROVIDES, WITHIN NURSERY AND SCHOOLAGE CENTERS, CARE AND EDUCATIONAL SUPERVISION FOR PRESCHOOL AND ELEMENTARY SCHOOL AGE CHILDREN. THE PHILOSOPHY OF THE CHILD CENTER PROGRAM IS BASED UPON THE BELIEF THAT EACH CHILD…
Unemployment has topped 7% nationally and economists predict it will approach 10% by 2010. Child care programs experience a trickle-down effect: when businesses cut back hours or lay people off, parents cut back child care hours or pull children from programs. "We're seeing more and more families lose their child care assistance and have nowhere…
Galpern, Lois; Hills, Tynette W.
The two major sections of this report discuss issues in employer-sponsored child care, specifically describing four child-care service alternatives. Issues emphasized in the discussion include the advantages of employment-related child care, financial considerations, and implications of various forms of sponsorship. Additional issues discussed are…
Herbst, Chris M.; Tekin, Erdal
Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…
It is important to recognize the political and policy accomplishments of the Patient Protection and Affordable Care Act (ACA), anticipate its limitations, and use the levers it provides strategically to address the problems it does not resolve. Passage of the ACA broke the political logjam that long stymied national progress toward equitable, quality, universal, affordable health care. It extends coverage for the uninsured who are disproportionately low income and people of color, curbs health insurance abuses, and initiates improvements in the quality of care. However, challenges to affordability and cost control persist. Public health advocates should mobilize for coverage for abortion care and for immigrants, encourage public-sector involvement in negotiating health care prices, and counter disinformation by opponents on the right. PMID:23409911
Zigler, E F; Finn-Stevenson, M
Ensuring the availability of high-quality, affordable child care to all families who need it is a goal of national importance. The authors suggest that a comprehensive financing and service delivery system for child care is needed to achieve this goal, and the system should ideally be grounded in an existing institution, already present in every community--the public school. The linkage of child care with the public education system would eliminate the false distinction between child care and education, and would create a universally accessible system of child care services for children. The School of the 21st Century is an example of such a system. Initially conceptualized by Zigler, it has now been implemented in 400 schools across 13 states, with the leadership and direction of Finn-Stevenson. This article describes how school districts that have implemented the program employ a mixture of parent fees and local, state, federal, and private dollars to fund it, and then proposes an ideal financing model for the program. In the ideal model, the same mix of funding sources would be retained, but a per-pupil expenditure of about $9,000 per year is advocated to deliver child care and other social services to three- and four-year-olds. Funds for initial start-up could be derived from reallocation of existing dollars, especially state prekindergarten programs, but eventually new funds would be needed to support ongoing operations. PMID:8972130
Blendon, Robert J; Benson, John M
In this analysis of data from 27 public opinion polls, the authors examine the role of the Affordable Care Act in the 2014 congressional elections. The outcome of the elections is likely to influence implementation of the ACA and future U.S. health care policy. PMID:25353968
Children Today, 1997
Describes potential collaborations between child care and child support enforcement agencies (CSEA). Child care resource and referral agencies can distribute information about child support enforcement and paternity establishment. CSEAs can provide training to child care providers. Child care subsidies may be linked to cooperation with the CSEA.…
The Affordable Care Act (ACA) will affect many aspects of health care across the nation, presenting both opportunities and challenges. Physicians who have a solid understanding of the recent industry trends and the role they will be playing in the post-ACA world will be able to better adapt to the new environment. This article analyzes the implications of the health care reform for physicians and offers recommendations on how to turn challenges into opportunities. PMID:26501969
This book of case studies highlights 26 municipalities involved in activities related to child care. Cities selected were of different sizes; were located in different parts of the country; and used diverse approaches for developing ways to improve access to affordable, high-quality child care. Each case study was developed through a telephone…
Center for Law and Social Policy, Inc. (CLASP), 2012
The Illinois Child Care Collaboration Program promotes collaboration between child care and other early care and education providers, including Early Head Start (EHS), by creating policies to ease blending of funds to extend the day or year of existing services. While no funding is provided through the initiative, participating programs may take…
... HUMAN SERVICES 45 CFR Part 156 RIN 0938-AR36 Patient Protection and Affordable Care Act; Data Collection... the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of... Services (the Secretary). The Affordable Care Act directs that the EHB reflect the scope of...
... Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support...: Notice. SUMMARY: This notice provides public announcement of CDC's intent to use Affordable Care Act (ACA....'' Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Title IV, Section...
Florida State Board of Community Colleges, Tallahassee.
This report describes the state-mandated review of Florida's child care programs. Florida's community colleges offer a total of six different degree or certificate programs in child care: Child Development and Education; Child Care Center Management; Child Development Early Intervention; Child Care Provider (discontinued in 98-99); Early Childhood…
Freeman, Margery, Ed.
Experiences of church-based child care advocates are narrated in this booklet. Introductory remarks argue that the National Council of Churches (NCC) must advocate high quality, affordable child care for all children and persuade church members to provide it. Part I tells stories about members' efforts to provide child care services to families:…
Eichman, Caroline; And Others
Sweeping changes in the economy, the makeup of the labor force, and family structure have altered both the family and the workplace, and have changed the way society must respond to family needs. The supply of child care is inadequate to meet families' child care needs, and many parents cannot afford to pay the full fees for child care. Public…
Hardy, Bradley; Hokayem, Charles; Ziliak, James P.
For parents of young children the decision to work strongly depends on the availability of affordable child care. Child care costs can take up a large portion of a family budget and may serve as an obstacle to work. In 2008 the National Association of Child Care Resource and Referral Agencies (NACCRRA) estimated that Kentucky families recently…
Strader, Kathleen; Counts, Jacqueline; Filene, Jill
The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…
Rotarius, Timothy; Liberman, Aaron
Health care is a big business. US health care expenditures reached $2.9 trillion in 2013. Patient spending accounted for 28% of the total, which means patients spent approximately $810 billion in 2013 for insurance premiums, deductibles, copays, coinsurance, and noncovered health care services. How are patients expected to pay almost a trillion dollars in health care expenses? There is a need to find a health care financing methodology that will make health care affordable for all patients and families. An alternative method for funding health care is discussed that includes creating a government-funded annuity during the first decade of one's life. When this annuity matures later in life, many individuals will have amassed a large pot of money with which to pay for their (and their family's) health care treatment and products. PMID:26506289
Gravett, Marty; And Others
Virginia's first state plan for child day care begins with 14 sections covering several aspects of child care. Section I reviews child care history and trends. Sections II, III, IV, and V argue, respectively, that child day care is important to government, business, families, and children. Elements of a comprehensive child day care delivery system…
Blau, David M.
Addressed to both social scientists and to nonacademic readers, this book provides an overview of the United States child care market, analyzes the main aspects of child care and child care policy, and proposes a new child care policy. The main thesis of the book is that the child care market functions much better than is commonly believed.…
Linsmeier, Dave; Richards, Dick; Routzong, Ed
Offers guidelines for putting a monetary value on a child care business. Discusses reasons for valuing the business, types of valuations (book, liquidation, and fair market), fair market valuation formulas, the corporate valuation, valuing assets included in a sale, and using experts. Also offers several tips for selling a child care business. (EV)
Aronson, Susan; Smith, Herberta
Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…
McDavid, Lolita M
Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. PMID:26318955
Goals for future child care services are discussed in this address. It is stressed that social service agencies should consider the family as a unit in providing flexible child care services. Other goals include: (1) tailoring child care programs to parent development as well as child development, (2) insuring that child care workers are motivated…
Harrist, Amanda W.; Thompson, Stacy D.; Norris, Deborah J.
Multiple perspectives regarding the definition of quality child care, and how child care quality can be improved, were examined using a focus group methodology. Participants were representatives from stakeholder groups in the child care profession, including child care center owners and directors (3 groups), parents (3 groups), child caregivers (3…
Fox, Jared B.; Shaw, Frederic E.
The Affordable Care Act requires many health plans to provide coverage for certain recommended clinical preventive services without charging copays or deductible payments. This provision could lead to greater uptake of many services that can improve health and save lives. Although the coverage provision is broad, there are many caveats that also apply. It is important for providers and public health professionals to understand the nuances of the coverage rules to help maximize their potential to improve population health. PMID:25393173
... Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and... Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial... Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation...
Rindfuss, Ronald R.; Guilkey, David K.; Morgan, S. Philip; KRavdal, Øystein
The child-care and fertility hypothesis has been in the literature for a long time and is straightforward: As child care becomes more available, affordable, and acceptable, the antinatalist effects of increased female educational attainment and work opportunities decrease. As an increasing number of countries express concern about low fertility, the child-care and fertility hypothesis takes on increased importance. Yet data and statistical limitations have heretofore limited empirical tests of the hypothesis. Using rich longitudinal data and appropriate statistical methodology, We show that increased availability of child care increases completed fertility. Moreover, this positive effect of child-care availability is found at every parity transition. We discuss the generalizability of these results to other settings and their broader importance for understanding variation and trends in low fertility. PMID:21174867
Johnson, Anna D.; Martin, Anne; Ryan, Rebecca M.
The evidence to date on the federal child care subsidy program’s effect on preschool child care quality is mixed. However, an as-yet untested outcome of subsidy receipt is subsequent child care choice. Specifically, it is possible that subsidy receipt in toddlerhood increases the likelihood of attending other publicly-funded preschool programs – Head Start and public pre-k – that provide the highest quality care available to low-income families. Using data from the ECLS-B, (n ≈ 2,100; beginning age=9 months), this study finds that subsidy receipt during toddlerhood predicts greater use of the other forms of publicly-funded care in the preschool year, although only if the earlier subsidy is used in a center. These results highlight a previously unconsidered potential benefit of the subsidy program. PMID:24919652
Rasmussen, Petra W; Collins, Sara R; Doty, Michelle M; Beutel, Sophie
By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick. PMID:25265646
Edwards, Samuel T; Abrams, Melinda K; Baron, Richard J; Berenson, Robert A; Rich, Eugene C; Rosenthal, Gary E; Rosenthal, Meredith B; Landon, Bruce E
The Patient-Centered Medical Home (PCMH) is a leading model of primary care reform, a critical element of which is payment reform for primary care services. With the passage of the Affordable Care Act, the Accountable Care Organization (ACO) has emerged as a model of delivery system reform, and while there is theoretical alignment between the PCMH and ACOs, the discussion of physician payment within each model has remained distinct. Here we compare payment for medical homes with that for accountable care organizations, consider opportunities for integration, and discuss implications for policy makers and payers considering ACO models. The PCMH and ACO are complementary approaches to reformed care delivery: the PCMH ultimately requires strong integration with specialists and hospitals as seen under ACOs, and ACOs likely will require a high functioning primary care system as embodied by the PCMH. Aligning payment incentives within the ACO will be critical to achieving this integration and enhancing the care coordination role of primary care in these settings. PMID:24687292
Child Care Action Campaign, New York, NY.
This paper presents an overview of the current status of child care in the United States. It provides a framework for discussing strategies to expand the supply of child care, improve its quality, and make it accessible to all families. Child care is defined, and factors that influence the quality of care are listed. The demand for child care is…
... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care...
Children's Foundation, Washington, DC.
This report presents the findings of the 1999 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 1998 study. Data on small family child care homes and group or large family child care homes are organized in 22 categories: (1) number of regulated homes; (2)…
Kelly, Nia, Comp.
This report presents the findings of the 2000 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 1999 study. Data on small family child care homes and group or large family child care homes are organized in 23 categories: (1) number of regulated homes; (2)…
Children's Foundation, Washington, DC.
This report presents the findings of the 2002 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2001 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…
Children's Foundation, Washington, DC.
This report presents the findings of the 2001 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2000 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…
Hollestelle, Kay; Koch, Pauline D.
This report presents the findings of the 2003 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2002 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…
This guidebook is a reference for family child care homes and family child care group homes licensed by the State of Alaska. It outlines licensing standards and procedures and serves as a simplified abstract of Alaska child care regulations. The first part is an overview that introduces home child care and licensing. Topics covered include…
This guide is designed to help employers hire a qualified child care consultant who will evaluate child care options in light of employees' needs and help develop and implement appropriate child care options. These options include: (1) establishment of a child care facility; (2) financial assistance; (3) a resource and referral service; (4)…
Office of Child Care, 2011
More than 12 million American children regularly rely on child care to support their healthy development and school success. Of these, over 1.6 million children receive a child care subsidy from the Child Care and Development Fund (CCDF) program each month. In addition, CCDF helps leverage child care investments from the Temporary Assistance for…
Haeder, Simon F
The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings. PMID:25316210
Johnson, Eric J; Hassin, Ran; Baker, Tom; Bajger, Allison T; Treuer, Galen
Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484
Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen
Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484
... HUMAN SERVICES 45 CFR Parts 155, 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act... Federal Register on March 27, 2012, entitled ``Patient Protection and Affordable Care Act; Establishment... rule regarding the codification of section 1413(c) of the Affordable Care Act. To align the...
... Medicaid eligibility changes under the Affordable Care Act (listed in more detail in 76 FR 51155) and... Services 42 CFR Parts 431, 435 and 457 Medicaid Program; Eligibility Changes Under the Affordable Care Act... Parts 431, 435, and 457 RIN 0938-AQ62 Medicaid Program; Eligiblity Changes Under the Affordable Care...
... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...
Rindfuss, Ronald R.; Guilkey, David; Morgan, S. Philip; Kravdal, Øystein; Guzzo, Karen Benjamin
Both sociological and economic theories posit that widely available, high-quality, and affordable child care should have pronatalist effects. Yet to date, the empirical evidence has not consistently supported this hypothesis. We argue that this previous empirical work has been plagued by the inability to control for endogenous placement of day care centers and the possibility that people migrate to take advantage of the availability of child care facilities. Using Norwegian register data and a statistically defensible fixed-effects model, we find strong positive effects of day care availability on the transition to motherhood. PMID:17583309
Harrington, Scott E
The minimum medical loss ratio (MLR) regulations in the Affordable Care Act guarantee that a specific percentage of health insurance premiums is spent on medical care and specified activities to improve health care quality. This paper analyzes the regulations' potential unintended consequences and incentive effects, including: higher medical costs and premiums for some insurers; less innovation to align consumer, provider, and health plan incentives, less consumer choice and increased market concentration; and the risk that insurers will pay rebates if claim costs are lower than projected when premiums are established, despite the regulations' permitted "credibility adjustments." The paper discusses modifications and alternatives to the MLR regulations to help achieve their stated goals with less potential for adverse effects. PMID:23720876
Snell, Emily K; Hindman, Annemarie H; Belsky, Jay
Evocative effects of child characteristics on the quality and quantity of child care were assessed in two studies using longitudinal data from the NICHD Study of Early Child Care. We focus on the influence of child characteristics on two important aspects of the child care experience: language stimulation provided by caregivers and quantity of care. In Study 1, associations between the developmental status of children aged 15 to 54 months and the language stimulation provided by their caregivers were examined using path models, and longitudinal child effects were detected across the earliest time points of the study. In Study 2, the associations among child behavior, temperament, development, and time in care were examined. Little evidence was found for such child effects on time in care. The results are discussed in terms of the effects of child care on child development and implications for developmental processes, particularly for children at greatest risk for developmental delay or psychopathology. PMID:26439062
Jones, Jacquelyn O.
Compiled to promote the development of high quality, affordable, and accessible day care programs in West Tennessee, this manual helps prospective child caregivers decide which kind of day care to operate and describes start-up steps and program operation. Section 1 focuses on five basic questions of potential caregivers: (1) Which type of child…
Preston, Michael A.; Gonzales, Gilbert
Disparities in health care have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care. PMID:25879149
Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti
The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies
Hirsch, Joshua A; Barr, Robert M; McGinty, Geraldine; Nicola, Gregory N; Schaefer, Pamela W; Silva, Ezequiel; Manchikanti, Laxmaiah
The Patient Protection and Affordable Care Act (ACA) became law on 23 March 2010. As part of the law, two independent boards were established. The Patient-Centered Outcomes Research Institute embodies national aspirations for employing comparative effectiveness research in healthcare decision-making, and the Independent Payment Advisory Board is focused on the need for a group of impartial experts to establish anticipatable growth rates for Medicare. Approximately 4 years after the bill was passed into law, these independent boards are at very different points in their life cycles. This article provides a status update. PMID:24962452
Many problems facing the Affordable Care Act would disappear if the nation were instead implementing Medicare for All - the extension of Medicare to every age group. Every American would be automatically covered for life. Premiums would be replaced with a set of Medicare taxes. There would be no patient cost sharing. Individuals would have free choice of doctors. Medicare's single-payer bargaining power would slow price increases and reduce medical cost as a percentage of gross domestic product (GDP). Taxes as a percentage of GDP would rise from below average to average for economically advanced nations. Medicare for All would be phased in by age. PMID:26124300
Brown, Ann L.; Johnson, Marilee
To compose a comprehensive description of the residential child care needs in Indiana, county agencies, county welfare departments, and probation departments were surveyed. Respondents were asked to identify the characteristics of children placed in Indiana residential facilities, in out-of-state residential care, and of those whom the agency was…
Morgan, Gwen G.
This paper presents a discussion of state and federal licensing and regulation of child care services. A hierarchy of the kinds of regulation is defined: (1) basic preventive/protective requirements (related to zoning, fire and safety, sanitation, and basic day care licensing); (2) administrative standards for publicly operated programs (equal to…
Nebraska State Dept. of Health and Human Services, Lincoln.
This guide enumerates regulations for anyone caring for four or more children at any one time in their home, from families other than their own, in the state of Nebraska. The purpose of the regulations is to protect and promote the health and safety of children in home based child care. The first section of the guide lists specific regulations for…
... child is safe and happy in a childcare environment that is fun, educational, and nurturing. Here are ... the opportunity to learn and grow in this environment? If none of the caregivers or childcare centers ...
... dental exams, and getting necessary treatments such as fluoride, extractions, fillings, or braces and other orthodontics. ... provider if your infant needs to take oral fluoride . THE FIRST TRIP TO THE DENTIST Your child's ...
Minnesota Child Care Resource and Referral Network, Rochester.
Intended for audiences with an interest in child care, this video examines the low compensation characteristic of the child care field and the social factors contributing to the low status and wages of caregivers. The video first looks at the social history of child care, noting that the function served by child care differed by social class. The…
Ferguson, T Bruce; Babb, Joseph A
The Affordable Care Act legislation that was passed by the US Congress and signed into law by President Obama on March 23, 2010 is having a substantial effect throughout all of health care in the United States. Cardiothoracic surgeons, as hospital-based procedural specialists, bring unique assets and certain important liabilities into this massive restructuring of our health care delivery system. This article highlights how each of the 10 titles in the Obamacare legislation might affect our specialty; its collaborative relationship with our cardiovascular, medical specialty, and primary care colleagues; and our clinical practice roles and responsibilities in accountable care organizations and primary care medical homes. This article also addresses the unique assets in clinical data in medicine and quality improvement demonstrated by our specialty that have been used to help shape the current and future landscape. Finally, key resources are identified to allow the cardiothoracic community to monitor the ongoing progress of Obamacare as implementation begins. Keeping abreast of these rapidly changing developments will be an important role for our specialty societies and for practitioners alike going forward. PMID:24673956
Council on Child Day Care and Early Childhood Programs, Richmond, VA.
School-age child care (SACC) programs based on-site in Virginia elementary schools were surveyed to determine the scope of such programs across the commonwealth, and to look more comprehensively at existing programs in terms of operators, activities, affordability, and other issues. In January 1993, the survey was sent to school superintendents in…
... With Serious Illness When Your Child's in the Pediatric Intensive Care Unit Caring for Siblings of Seriously Ill Children Preparing Your Child for Surgery Managing Home Health Care Marriage Advice for Parents of Children ...
Swartz, Katherine; Hall, Mark A; Jost, Timothy S
Prior to the Affordable Care Act (ACA), most states' individual health insurance markets were dominated by one or two insurance carriers that had little incentive to compete by providing efficient services. Instead, they competed mainly by screening and selecting people based on their risk of incurring high medical costs. One of the ACA's goals is to encourage carriers to participate in the health insurance marketplaces and to shift the focus from competing based on risk selection to processes that increase consumer value, like improving efficiency of services and quality of care. Focusing on six states--Arkansas, California, Connecticut, Maryland, Montana, and Texas--this brief looks at how carriers are competing in the new marketplaces, namely through cost-sharing and composition of provider networks. PMID:26159009
Frank, Richard G; Beronio, Kirsten; Glied, Sherry A
Prior to the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Patient Protection and Affordable Care Act (ACA), about 49 million Americans were uninsured. Among those with employer-sponsored health insurance, 2% had coverage that entirely excluded mental health benefits and 7% had coverage that entirely excluded substance use treatment benefits. The rates of noncoverage for mental and substance use disorder care in the individual health insurance markets are considerably higher. Private health insurance generally limits the extent of these benefits. The combination of MHPEA and ACA extended overall health insurance coverage to more people and expanded the scope of coverage to include mental health and substance abuse benefits. PMID:24483783
Zaslow, Martha; Halle, Tamara; Martin, Laurie; Cabrera, Natasha; Calkins, Julia; Pitzer, Lindsay; Margie, Nancy Geyelin
This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review…
Weinraub, Marsha; Shlay, Anne B.; Harmon, Michelle; Tran, Henry
To evaluate the type and quality of child care used by low-income families who were either receiving or not receiving subsidized child care, we interviewed 111 African American parents from a randomly selected sample of low-income families. We inquired about their child-care use, satisfaction with care, work stress, and employment history. Using…
Lippman, Laura; Vandivere, Sharon; Keith, Julie; Atienza, Astrid
For many low-income and single parents, employment depends on securing reliable, affordable child care. Yet these parents may face greater challenges than do higher-income and two-parent families in making affordable, appropriate child care arrangements that complement their work schedules. Indeed, the cost, availability, stability, and quality of…
As health care reform in the US evolves beyond insurance reform to encompass delivery system reform, the opportunity arises to harness the Affordable Care Act to strengthen patient care in America. One area for dedicated individuals to lead this effort is by improving transitions in patient care across the continuum of team members, specialties, settings, and systems. This article will describe innovations of the surgicalist and acute care surgeon that have emerged in response to the challenges facing surgery in specialization, geography, and the need to comply with health care reform mandates. Three ways will be described to integrate these innovations with pilot programs in the Affordable Care Act: to promote teamwork, to reduce readmissions, and to strengthen emergency care because the key location where the joint efforts intersect most acutely with patient need is in our nation’s Emergency Departments. PMID:25663212
To assess the effectiveness of the child care delivery system in Evanston, Illinois, a study was conducted of parent and caregiver perceptions of the affordability, availability, accessibility, and quality of local child care services. Questionnaires were distributed to the directors of 14 local child care centers and to 832 parents currently…
Families and Work Inst., New York, NY.
Produced as a touchstone for the White House Conference on Child Care, this brief video (5 minutes) presents a collage of voices speaking on the need for quality child care. The voices include those of parents, physicians and child development experts, and child care workers. Among the threads touched upon by these voices are working mothers, the…
... Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule, 76 FR 41866 (July 15...) Requirements Under the Patient Protection and Affordable Care Act; Interim Final Rule, 75 FR 74864, 74918-20... of the Patient Protection and Affordable Care Act and the Health Care and Education...
... Baby teeth hold space for adult teeth. Take care of your child’s teeth to protect your child from tooth decay (cavities). Tooth decay can: Cause your child pain Make it hard for your child to chew ...
Baker, Dean; Jorgensen, Helene
Many opponents of the Affordable Care Act (ACA) predicted the law would hurt employment. A common complaint was that the requirement that firms employing more than 50 employees either provide insurance for employees working more than 30 hours a week or pay a penalty would lead many firms to cut back workers' hours to just below the 30-hour cutoff. This article uses the Current Population Survey to compare the share of workers employed between 25-29 hours in the first four months of 2013 with the same months of 2012. While the Obama administration subsequently delayed the application of this portion of the ACA, at the time larger employers would have expected to be subject to the insurance requirement. The analysis found the share of employment in this hour band was slightly lower in 2013 than in 2012. PMID:26460453
Maher, Brendan S
The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate. PMID:25335202
Manthous, Constantine A.; Sofair, Andre N.
Background: Medicaid is the federal program, administered by states, for health care for the poor. The Affordable Care Act (ACA) has added a large number of new recipients to this program. Hypothesis: Medicaid programs in some, if not many, states do not provide patients uniform access to subspecialty care guaranteed by the federal statutes. Insofar as the ACA does not address this pre-existing “sub-specialty gap” and more patients are now covered by Medicaid under the ACA, the gap is likely to increase and may contribute to disparities of health care access and outcomes. Methods: A brief description of previous studies demonstrating or suggesting a subspecialty gap in Medicaid services is accompanied by perspectives of the authors, using published literature — most notably the Denver, Colorado health care system — to propose various solutions that may be deployed to address gaps in subspecialty coverage. Results: All published studies describing the Medicaid subspecialty gap are qualitative, survey designs. There are no authoritative objective data regarding the exact prevalence of gaps for each subspecialty in each state. However, surveys of caregivers suggest that gaps were prevalent in the United States prior to initiation of the ACA. Even fewer papers have addressed solutions (in light of the paucity of data describing the magnitude of the problem), and proposed solutions remain speculative and not grounded in objective data. Conclusions: There is reason to believe that a substantial proportion of U.S. citizens — those who are guaranteed a full complement of health services through Medicaid — have difficult or no access to some subspecialty services, many of which other citizens take for granted. This problem deserves greater attention to verify its existence, quantify its magnitude, and develop solutions. PMID:25506291
Jones-Branch, Julie A.; Torquati, Julia C.; Raikes, Helen; Edwards, Carolyn Pope
This study compared the quality of child care programs serving children receiving government subsidies to those not serving such children. Thirty-four classrooms in full day programs serving preschool aged children (19 subsidized, 15 unsubsidized) were observed using the Early Childhood Environment Rating Scales-Revised (ECERS-R). (1) Research…
Provides advice on how to set up child day-care services within a school to allow teen mothers to continue their education. Among the advice given are to provide a comprehensive program, be prepared for resistance, tap multiple funding sources, pay attention to staff training and necessary paperwork, have clear guidelines and rules, and be…
Child Care Information Exchange, 1998
Lists 16 firms that offer child care consulting services to employers and communities. Each entry includes a brief description of the firm and its services, contact person, address, and phone and fax numbers. Some include e-mail and Web site addresses. (TJQ)
Community Coordinated Child Care (4-C) for Central Florida, Inc., Orlando.
This brief report argues against the cost analysis process currently used as a form of rate justification by states and central agencies who are purchasing child care. Instead, a logic is proposed for negotiated rates based on expected levels of necessary costs and reasonable rates in comparison with open market levels as shown on day care…
Ung, Brian L; Mullins, C Daniel
The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142
Surveys how states are investing new federal money in child care quality and supply. Examines several key areas: child care licensing and monitoring; resource and referral services; child care for infants, school-agers, and children with special needs; child care for low-income families; comprehensive and enriched services; provider training;…
Morrissey, Taryn W.; Warner, Mildred E.
Child-care vouchers are becoming more common and can provide child-care assistance to a wide spectrum of the population. There is little empirical research, however, on which workers participate in their employer's child-care programs. In this exploratory study, employees with children at 1 large university completed questionnaires to gather…
Hawkeye Area Community Action Program, Cedar Rapids, IA.
This report describes ways in which older persons may become involved in the field of home child care. It is intended to provide (1) detailed information on an intergenerational child care (IGCC) program; (2) general information relating to intergenerational contacts and home child care; and (3) "how-to" information for agencies planning to…
Children's Foundation, Washington, DC.
This report details a survey of state child care regulatory agencies. Data on both small family child care homes (FCCH) and group or large family child care homes (LCCH or GCCH) are included and organized into 22 categories: (1) number of regulated homes; (2) definitions and regulatory requirements; (3) unannounced inspection procedure; (4)…
Children's Foundation, Washington, DC.
This report details the findings of an annual survey of state child care regulatory agencies. The survey gathered data on both small family child care homes and group or large family child care homes in each of the 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. The report's introduction lists the survey categories and…
California Dept. of Health Services, Oakland. Childhood Lead Poisoning Prevention Branch.
In an effort to address young children's substantial risk for exposure to lead in out-of-home child care programs, outreach and training were developed for child care providers. This workshop curriculum consists of training activities and materials appropriate for child care providers in centers or homes for the purpose of educating them about the…
Shillady, Amy, Ed.
The "Child Care Bulletin" is published quarterly and includes practical, informative articles based on current literature regarding topics important to policy-makers, child care providers, and parents. The Bulletin includes short articles, tips sheets, policy updates, interviews with leaders in the child care field, information from child…
Schmidt, Lori, Ed.
In Canada today, more than a million children spend a large portion of their preschool years in child care outside the immediate family. The design of a child care center's physical facility has a major impact on the quality of interactions that take place within it. Intended to assist design and child care professionals who are building a new…
This report describes the impact of nurse consultant services to child care programs in Colorado on the children, parents, and staff of the centers they serve as part of the Healthy Child Care Colorado (HCCC) initiative. Study participants included 25 child care center directors and 24 nurse consultants, representing large and small centers in…
Burchinal, Margaret R.; Cryer, Debby
It is widely accepted that high quality child care enhances children's cognitive and social development, but some question whether what constitutes quality care depends on the child's ethnic and cultural background. To address this question, secondary analysis of data from the two largest studies of child care experiences in the United States,…
Ferguson, Roy, Ed.; And Others
This book provides a comprehensive analysis of the child and youth care field in Canada. It covers a spectrum of key concerns within the field of child and youth care, and presents an analysis that spans a variety of program areas. The 12 chapters in the book are: (1) "The Scope of Child and Youth Care in Canada" (Roy Ferguson and others); (2)…
Jacobs, Ellen; And Others
This paper examines on-site, school-age child care and the relationship between attendance at on-site, after-school child care programs and familial, environmental, and developmental factors. Topics discussed include: (1) the quality of school-based environments in kindergarten and child care; (2) the socioeconomic status and size of families of…
Young children's experiences outside of both home and school are important for their development. As women have entered the labor force, child care has become an increasingly important context for child development. Child care experiences prior to school entry have been well-documented as important influences on children's academic and…
Child Care Law Center, San Francisco, CA.
This booklet provides answers to 12 questions about the rights and responsibilities of child care providers in California concerning the issue of child abuse. The questions are (1) Who is a "Child Care Custodian?" (2) How do I decide whether or not to report? (3) How do I recognize 'abuse' and 'neglect'? (4) How and when should I tell the parent…
Seibel, Nancy L.; Gillespie, Linda G.; Temple, Tabitha
Child care providers are likely to be the professionals who most frequently interact with families with young children. Thus, infant and toddler child care providers are uniquely positioned to recognize and respond to families' needs for information and support. This article describes knowledge, skills, and strategies that support child care…
Wurtele, Sandy K.; Schmitt, Ann
This study examined the knowledgeability of child care workers (n=97) regarding their rights and responsibilities in reporting suspected child sexual abuse. Day care personnel knew significantly less about procedures for reporting suspected abuse and their protection under the law (when compared to child sexual abuse experts). (Author/DB)
... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... Care Act (ACA) appropriations to the Connecticut Department of Public Health and the Georgia...
... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Centers (U48).'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective...
Dalen, James E; Waterbrook, Keith; Alpert, Joseph S
The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congressmen, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it. Polls have consistently shown that it is supported by <50% of Americans. The most important goal of the ACA is to improve the health of Americans by increasing the number covered by health insurance. In the first year of its implementation, more than 10 million citizens gained health insurance. The percentage of Americans without health insurance decreased from 18% in July 2013 to 13.4% in June 2014. In addition, the ACA has eliminated many of the negative features of private insurance such as the denial of coverage for those with "prior conditions." The benefits of Medicare have been enhanced to decrease the cost of prescription drugs and to eliminate co-pays for preventive services. Despite these positive changes, a near majority of Americans still oppose the ACA, even though they approve of most of its features. They oppose the mandate that all Americans must have health insurance (the individual mandate), and they oppose a government role in health care. Yet Medicare, a mandatory insurance for seniors administered by the federal government since 1965, is overwhelmingly approved by the American public. The opposition to a government role in health care is based on the fact that that the vast majority of our citizens do not trust their government. Republicans are much less trusting of the federal government and much less supportive of a government role in health care than Democrats. The overwhelmingly negative TV ads against the ACA by the Republican candidates in the elections of 2012 and 2014 have had a major impact on Americans' views of the ACA. More than 60% of Americans have stated that most of what they know about the ACA came from watching TV. Opposition to a government role in health care
Sharma, A; Gupta, S
In 1924, the League of Nations adopted the 1st international law recognizing that children have inalienable rights and are not the property of their father. The UN Declaration on the Rights of the Child emerged in 1959. 1979 was the International Year of the Child. In 1990 there was the World Summit on Children and the UN General Assembly adopted the Global Convention on the Rights of the Child. The convention included civil, economic, social, cultural, and political rights of children all of which covered survival, development, protection, and participation. At the end of 1990, 60 countries had ratified the convention, thus including it into their national legislation. Even though India had not yet endorsed the Convention by the end of 1991, it expressed its support during the 1st workshop on the Rights of the Child which focused on girls. India has a history of supporting children as evidenced by 250 central and state laws on their welfare such as child labor and child marriage laws. In 1974, India adopted the National Policy for Children followed by the establishment of the National Children's Board in 1975. The Board's activities resulted in the Integrated Child Development Services Program which continues to include nutrition, immunization, health care, preschool education, maternal education, family planning, and referral services. Despite these laws and actions, however, the Indian government has not been able to improve the status of children. For example, between 1947-88, infant mortality fell only from 100/1000 to 93/1000 live births and child mortality remained high at 33.3 in 1988 compared with 51.9 in 1971. Population growth poses the biggest problem to improving their welfare. Poverty also exacerbates their already low status. PMID:12317284
Mechanic, David; Olfson, Mark
Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce. PMID:26666969
General Accounting Office, Washington, DC. Health, Education, and Human Services Div.
Prepared to assist Congress in its deliberations of various child care proposals, this report identifies key child care center standards that are critical in helping to ensure high quality child care. The article also examines the extent to which states incorporate these standards into their own standards, and discusses other important issues that…
Sap, Maarten; Schwartz, Andrew; Town, Robert; Baker, Tom; Ungar, Lyle; Merchant, Raina M
Background Traditional metrics of the impact of the Affordable Care Act (ACA) and health insurance marketplaces in the United States include public opinion polls and marketplace enrollment, which are published with a lag of weeks to months. In this rapidly changing environment, a real-time barometer of public opinion with a mechanism to identify emerging issues would be valuable. Objective We sought to evaluate Twitter’s role as a real-time barometer of public sentiment on the ACA and to determine if Twitter sentiment (the positivity or negativity of tweets) could be predictive of state-level marketplace enrollment. Methods We retrospectively collected 977,303 ACA-related tweets in March 2014 and then tested a correlation of Twitter sentiment with marketplace enrollment by state. Results A 0.10 increase in the sentiment score was associated with an 8.7% increase in enrollment at the state level (95% CI 1.32-16.13; P=.02), a correlation that remained significant when adjusting for state Medicaid expansion (P=.02) or use of a state-based marketplace (P=.03). Conclusions This correlation indicates Twitter’s potential as a real-time monitoring strategy for future marketplace enrollment periods; marketplaces could systematically track Twitter sentiment to more rapidly identify enrollment changes and potentially emerging issues. As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape. PMID:25707038
The demand for child care services in the United States continues to grow, stretching the levels of program quality to the limit. In fact, the country is facing a crisis in child care. Affordable child care continues to be a major issue for many families. Solutions to the current crisis in child care must, in addition to insuring affordability,…
Owen, Margaret Tresch; Klausli, Julia F.; Mata-Otero, Ana-Maria; Caughy, Margaret O'Brien
Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were…
Claffey, Anne; And Others
Discusses the conflicts arising from the child care teacher's dual role as employee and parent. Examines issues such as separation from the infant, return to work, child care arrangements, placement of the child in the same room as the parent, and nursing arrangements. Concludes that dual role must be respected. (BAC)
The National Institute of Child Health and Human Development (NICHD) Study of Early Child Care has enrolled more than 1,300 children and followed most of them through the first 7 years of their lives to determine how variations in child care are related to their development. This booklet describes the study and its findings. Findings are divided…
This publication of the California Governor's Advisory Committee on Child Development Programs includes four issues papers dealing with employer sponsored child care. The first paper describes three approaches to employer support of child care, lists the elements of the system planners must consider when designing appropriate responses to…
... provisions of PHS Act section 2719 on July 23, 2010, at 75 FR 43330. Section 2719(b)(1) of the PHS Act and... Administration 29 CFR Part 2590 Affordable Care Act; Federal External Review Process; Request for Information... Act, as amended by the Affordable Care Act, and its implementing regulations. DATES: Submit written...
Children's Defense Fund, Washington, DC.
Millions of children in the United States are left in inadequate day care situations every day or live in poverty because their parents cannot afford day care and therefore cannot work. The number of working mothers is rising, and these mothers deserve high quality day care and after-school care for their children. This publication lists important…
Webb, Lauren; Shah, Parag K; Harisiades, James P; Boudos, Rebecca; Agrawal, Rishi
Enrollment of young adults is foundational to the success of the Affordable Care Act (ACA). This article analyzes the implications for young adults transitioning from pediatric to adult care with the implementation of the ACA. We review the key characteristics of this population relevant to health care utilization and access as well as the impact of private insurance market reforms, health insurance marketplaces, Medicaid expansion, and workforce development provisions on this population. We then analyze how reform is impacting and will continue to impact specific populations of young adults, including individuals with disabilities, college students, immigrants, young adults who age out of the foster care system and individuals involved with the criminal justice system. Finally, we look at the socio-economic and political factors influencing outreach efforts, and make recommendations to maximize the benefits of the law for young adults to empower them to have access to care and financial security. PMID:25737348
Barcellos, Silvia Helena; Wuppermann, Amelie C.; Carman, Katherine Grace; Bauhoff, Sebastian; McFadden, Daniel L.; Kapteyn, Arie; Winter, Joachim K.; Goldman, Dana
This paper investigates whether individuals are sufficiently informed to make reasonable choices in the health insurance exchanges established by the Affordable Care Act (ACA). We document knowledge of health reform, health insurance literacy, and expected changes in healthcare using a nationally representative survey of the US population in the 5 wk before the introduction of the exchanges, with special attention to subgroups most likely to be affected by the ACA. Results suggest that a substantial share of the population is unprepared to navigate the new exchanges. One-half of the respondents did not know about the exchanges, and 42% could not correctly describe a deductible. Those earning 100–250% of federal poverty level (FPL) correctly answered, on average, 4 out of 11 questions about health reform and 4.6 out of 7 questions about health insurance. This compares with 6.1 and 5.9 correct answers, respectively, for those in the top income category (400% of FPL or more). Even after controlling for potential confounders, a low-income person is 31% less likely to score above the median on ACA knowledge questions, and 54% less likely to score above the median on health insurance knowledge than a person in the top income category. Uninsured respondents scored lower on health insurance knowledge, but their knowledge of ACA is similar to the overall population. We propose that simplified options, decision aids, and health insurance product design to address the limited understanding of health insurance contracts will be crucial for ACA’s success. PMID:24706843
Kautter, John; Pope, Gregory C; Keenan, Patricia
Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences. PMID:25364625
American Psychologist, 2006
This report summarizes findings from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development as effect sizes for exclusive maternal care and--for children in child care--type, quality, and quantity of care. Children (n = 1,261) were recruited at birth and assessed at 15, 24, 36, and 54 months.…
Delineates significant developments in the employer- sponsored child care arena. Highlights predictions from chief executive officers of the largest employer child care organizations for the most significant trends in employer child care: slowing growth, consolidation, increasing demands for back-up care, globalization, and multi-site strategies.…
California Child Care Resource and Referral Network, San Francisco.
This compendium provides standardized data on child care supply and requests for care in California. It provides county and statewide information based on responses from more than 38,000 child care providers and about 45,000 requests for child care, including: (1) key demographic statistics; (2) county population; (3) children in poverty; (4)…
Hawkinson, Laura E.
Research using an experimental design is needed to provide firm causal evidence on the impacts of child care subsidy use on child development, and on underlying causal mechanisms since subsidies can affect child development only indirectly via changes they cause in children's early experiences. However, before costly experimental research is…
Duska, Linda R; Engelhard, Carolyn L
The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, affordable, and comprehensive across different parts of the country. For our cancer patients and our practices, the ACA has implications that are both positive and negative. The Medicaid expansion and access to insurance exchanges are intended to increase the number of insured patients and thus improve access to care, but many states have decided to opt out of the Medicaid program and in these states access problems will persist. Screening programs will be put in place for insured patients but may supplant federally funded programs that are currently in place for uninsured patients and may not follow current screening guidelines. Both hospice and home health providers will be asked to provide more services with less funding, and quality measures, including readmission rates, will factor into reimbursement. Insured patients will have access to all phases of clinical trial research. There is a need for us as providers of Gynecologic Oncology care to be active in the implementation of the ACA in order to ensure that our patients and our practices can survive and benefit from the changes in health care reimbursement, with the ultimate goals of improving access to care and quality while reducing unsustainable costs. PMID:23500090
Sallee, Alvin L.
To further understanding of the complex issues regarding the provision of day care services, this paper presents an historical overview of national child care policy in the United States, and discusses the dimensions of working families' need for child care; the central policy issue of the relationship between work and the family; and incentives,…
Joseph, Tiffany D
The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide. PMID:26567382
Floyd, Latosha; Phillips, Deborah A.
The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a…
This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making. PMID:26567380
Brower, Mary R.; Sull, Theresa M.
Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…
Willer, Barbara; And Others
This document reports the results of two coordinated studies of early education and care in the United States. Information on child care demand was provided through the National Child Care Survey 1990 (NCCS), which involved interviews with 4,392 parents. Information on child care supply was provided by A Profile of Child Care Settings (PCS), which…
Johnson, Anna D.; Martin, Anne; Ryan, Rebecca M.
The evidence to date on the federal child-care subsidy program's effect on preschool child-care quality is mixed. However, an as-yet untested outcome of subsidy receipt is subsequent child-care choice. Specifically, it is possible that subsidy receipt in toddlerhood increases the likelihood of attending other publicly funded preschool…
Children's Foundation, Washington, DC.
This report presents the results of a nationwide survey of state agencies charged with regulating or licensing family child care. An introduction contains information on survey methodology, a summary of regulatory requirements for family child care homes and group (large) child care homes, and a survey question and answer summary. The body of the…
Children's Foundation, Washington, DC.
This report presents the results of a nationwide survey of state agencies charged with regulating or licensing family child care. An introduction contains information on survey methodology, a summary of regulatory requirements for family child care homes and group (large) child care homes, and a survey question and answer summary. The body of the…
Child Trends, 2010
This paper presents a profile of Iowa's Child Care Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile is divided into the following categories: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family Child Care Programs;…
Today employer child care is accepted as standard benefit for employees and nearly all Fortune 500 companies have gotten involved. The current recession threatened to halt the growth of employer child care as companies consolidated, cut back, and folded. However, in reviewing the status of employer child care for this trend report, it appears that…
Nielsen, Dianne Miller
Describes the transformation of women from babysitters to child care professionals as a result of becoming a family child care provider in the U.S. military Family Child Care (FCC) program. Discusses application process, orientation training, the use of peer mentors, initial setup, inspections, enrollment, caregiver training, and accreditation.…
Blau, David M.
The effect of child care regulations on outcomes in the child care market and the labor market for mothers of young children is examined. The analysis uses a time series of cross sections and examines the robustness of previous cross-section findings to controls for state-level heterogeneity. Child care regulations as a group have statistically…
National Inst. of Child Health and Human Development (NIH), Bethesda, MD. Early Child Care Network.
A longitudinal study explored the effects of different aspects of child care on infants' attachment security. Child care variables examined included age of entry; the quality, amount, stability, and type of care; and mother's sensitivity to the child's needs. When the validity of the Strange Situation was tested by comparing children with low and…
Ryan, Rebecca M.; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne
In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government's largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the…
Reisman, Barbara; And Others
The Child Care Action Campaign commissioned research from nine leading economists and policy analysts for the purpose of focusing attention on the link between economic well-being and child care. After the preparation of the research, a national convention was convened to discuss the connection between child care and economic well-being, and to…
Whitebook, Marcy, Comp.; And Others
This early childhood education text was designed to help students and child care staff become effective advocates for the improvement of quality, salaries, and working conditions in child care programs. Unit I provides literature on the issues affecting the child care field and focuses on strategies to improve salaries and working conditions.…
Oklahoma State Dept. of Education, Oklahoma City.
This handbook details requirements for family day care homes in Oklahoma for providing child nutrition through the Child and Adult Care Food Program. The handbook includes contact information for state consultants. The basic responsibilities for sponsors of family day care home child nutrition programs are outlined, and the sponsoring organization…
Delaware Valley Child Care Council, Philadelphia, PA.
This booklet discusses the current child care crisis and suggests a solution to the crisis. The gap between the cost of child care and parents' ability to pay is restricting the expansion and availability of child care services and undercutting the quality of child care. The average cost of full-day child care in the Delaware Valley, Pennsylvania,…
Rigby, Elizabeth; Ryan, Rebecca M.; Brooks-Gunn, Jeanne
Using data from the Child Care Supplement to the Fragile Families and Child Wellbeing Study, we test associations between the quality of child care and state child care policies. These data, which include observations of child care and interviews with care providers and mothers for 777 children across 14 states, allow for comparisons across a…
Van Leuven, Patricia O'Brien
Background information and recommendations related to the support of child care services in Fort Wayne, Indiana is presented in six chapters. Chapter I discusses the feminization of the workforce and demographic data bearing on the need for child care, the child care workforce, and child care arrangements. Chapter II reviews child care services in…
Seguret, M. C.
Examines the attitudes of the public authorities in various countries concerning child-care services for working parents and the different systems of care in operation in industrial and developing nations. (Author/CT)
Background checks involve gathering information from state and federal databases to determine if child care providers have a history of child abuse or other criminal convictions that would make them unacceptable for working with children. Background checks include state criminal history checks, state child abuse registry checks, and Federal Bureau…
Myerson, Rebecca; Laiteerapong, Neda
This article reviews available data on the implications of the Affordable Care Act (ACA) for the diagnosis and care of type 2 diabetes. We provide a general overview of the major issues for diabetes diagnosis and care, and describe the policies in the ACA that affect diabetes diagnosis and care. We also estimate that approximately 2.3 million of the 4.6 million people in the USA with undiagnosed diabetes aged 18-64 in 2009-2010 may have gained access to free preventive care under the ACA, which could increase diabetes detection. In addition, we note two factors that may limit the success of the ACA for improving access to diabetes care. First, many states with the highest diabetes prevalence have not expanded Medicaid eligibility, and second, primary care providers may not adequately meet the increase in Medicaid patients because federal funding to increase provider reimbursement for Medicaid visits recently expired. We close by discussing current gaps in the literature and future directions for research on the ACA's impact on diabetes diagnosis, care, and health outcomes. PMID:26892908
This article reviews available data on the implications of the Affordable Care Act (ACA) for the diagnosis and care of type 2 diabetes. We provide a general overview of the major issues for diabetes diagnosis and care, and describe the policies in the ACA that affect diabetes diagnosis and care. We also estimate that approximately 2.3 million of the 4.6 million people in the USA with undiagnosed diabetes aged 18–64 in 2009–2010 may have gained access to free preventive care under the ACA, which could increase diabetes detection. In addition, we note two factors that may limit the success of the ACA for improving access to diabetes care. First, many states with the highest diabetes prevalence have not expanded Medicaid eligibility, and second, primary care providers may not adequately meet the increase in Medicaid patients because federal funding to increase provider reimbursement for Medicaid visits recently expired. We close by discussing current gaps in the literature and future directions for research on the ACA’s impact on diabetes diagnosis, care, and health outcomes. PMID:26892908
Ford, Carol A.; French, Benjamin; Rubin, David M.
Objectives. We sought to describe changes in young adults’ routine care and usual sources of care (USCs), according to provider specialty, after implementation of extended dependent coverage under the Affordable Care Act (ACA) in 2010. Methods. We used Medical Expenditure Panel Survey data from 2006 to 2012 to examine young adults’ receipt of routine care in the preceding year, identification of a USC, and USC provider specialties (pediatrics, family medicine, internal medicine, and obstetrics and gynecology). Results. The percentage of young adults who sought routine care increased from 42.4% in 2006 to 49.5% in 2012 (P < .001). The percentage identifying a USC remained stable at approximately 60%. Among young adults with a USC, there was a trend between 2006 and 2012 toward increasing percentages with pediatric (7.6% vs 9.1%) and family medicine (75.9% vs 80.9%) providers and declining percentages with internal medicine (11.5% vs 7.6%) and obstetrics and gynecology (5.0% vs 2.5%) providers. Conclusions. Efforts under the ACA to increase health insurance coverage had favorable effects on young adults’ use of routine care. Monitoring routine care use and USC choices in this group can inform primary care workforce needs and graduate medical education priorities across specialties. PMID:26447914
Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T
The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655
Mayfield, Margie I.
This study provides information on work-related child care programs and services in Canada today. In an overview of the subject, Chapter 1 discusses the criteria used to select programs for presentation in the study; defines work-related child care; and examines the increasing number of women in the workplace and the adaptation of the workplace to…
... consultant to create a policy that fits your child care center or home. Safe Sleep Practices Practice SIDS reduction ... questions about safe sleep practices please contact Healthy Child Care America at the American Academy of Pediatrics at email@example.com or 888/227-5409. Remember, if ...
Morda, Romana; Kapsalakis, Anthoula; Clyde, Margaret
A study examining child care services in rural and remote areas conducted focus group interviews and distributed questionnaires to parents living in 15 towns in the Mallee region of Western Victoria (Australia). Barriers to accessing child care in rural areas included limited availability of formal services, costs, stereotypes associated with life…
Whitebook, Marcy; And Others
Including excerpts from contracts protecting unionized child care workers, this booklet explains basic terminology and facts about unionizing and addresses child care workers' concerns. Section 1 answers commonly asked questions about unions and offers advice about how to answer parents' questions about workers' attempts to organize. Section 2…
The amount of state legislation dealing with child care issues has significantly increased in the last 5 years. This report focuses on state strategies for expanding and improving the child care system through incentives and support for employers and providers. State policymakers are exploring partnerships of public and private resources for…
Everts, Joanne; And Others
Discusses employer-sponsored child care, specifically on college and university campuses and briefly reviews history and status of campus children's centers. Describes campus child care provided at University of Nevada, Reno. Shows how important it is for institutions to develop a corporate culture that is truly family friendly. Proposes agenda…
Working for Change, 1995
This journal issue highlights examples of state and local child care advocacy strategies that have resulted in positive legislative change or increased funding for low-income child care. Legal constraints on lobbying by nonprofit or public agencies due to limitations imposed by the U.S. Internal Revenue Service and public and private funding…
Aronson, Susan S.
Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…
This report is one in a series of studies by the Children's Defense Fund examining state policies and practices in child care and early childhood education. It is based on comprehensive surveys conducted in all 50 states and the District of Columbia in 1991 and 1993 to examine Aid to Families with Dependent Children (AFDC) child care policies and…
Perlman, Michal; Fletcher, Brooke A.
The purpose of this study was to describe literacy instruction in child care centers, examine aspects of child care center quality that may predict such instruction, and provide a limited analysis of whether literacy instruction impacts children's concurrent pre-academic functioning. Staff and children in 103 classrooms serving preschool-age…
At the beginning of 2009, with the country facing the worst of the economic crisis, the president and Congress understood that Americans needed help paying for child care to get back to work in the recession. As part of the American Recovery and Reinvestment Act, they allocated an additional $2 billion for the Child Care and Development Block…
Project Challenge is a unit of Project Playpen, Inc., in Pinellas County, Florida, which serves children from birth to age 5 who attend child care programs and display mild to moderate degrees of emotional challenge. This program guide describes the activities, structures, and design of Project Challenge to meet the needs of child care for working…
This paper envisions child care problems in the year 2000 and explores their relationship to policies of today. The population entering parenting age in the year 2000 will bear the scars of the inadequate child care policies of the 1980's. New poor and black parents--many of them born to adolescent mothers in the early 1980's--will have been…
The intent of this article is to follow deconstruction as a way to think about the questions that are currently being asked in Child and Youth Care (CYC). As a graduate student in the School of Child and Youth Care at the University of Victoria (SCYC), I am challenged to think my position and identity in terms of my location within, or on the…
Rose, Katherine Kensinger; Elicker, James
In an effort to address how to best assess the importance of various characteristics of child care to parents, 355 employed mothers of children under 6 years of age completed a questionnaire exploring the importance of child care characteristics to their choice of arrangement, through ratings, rankings, and conjoint analysis. Results indicate that…
Blank, Helen; Wilkins, Amy
This fact book presents findings of the Children's Defense Fund's fourth annual survey on child care funding and priorities, and consists of five sections which provide an overview of states' child care activities, information about specific policies, and contacts in each state who can provide more detailed information. Section 1 presents recent…
Sayre, Nancy E.
This paper proposes state regulations for the training of child care staff members in developmentally appropriate safe aquatic practices, outlines required features of any pools that children visit, and suggests safe practices for water-related activities at child care centers and swimming pools. The staff training regulation suggestions include…
Floyd, Latosha; Phillips, Deborah A
The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network with nearly 23,000 workers that directly serves or subsidizes care for 200,000 children every day. Child-care options available to civilians typically pale in comparison, and the military's system, embedded in a broader web of family support services, is widely considered to be a model for the nation. The military's child-care success rests on four pillars, write Major Latosha Floyd and Deborah A. Phillips. The first is certification by the military itself, including unannounced inspections to check on safety, sanitation, and general compliance with DoD rules. The second is accreditation by nationally recognized agencies, such as the National Association for the Education of Young Children. The third is a hiring policy that sets educational and other requirements for child-care workers, and the fourth is a pay scale that not only sets wages high enough to discourage the rapid turnover common in civilian child care but also rewards workers for completing additional training. Floyd and Phillips sound a few cautionary notes. For one, demand for military child care continues to outstrip the supply In particular, as National Guard and Reserve members have been activated during the wars in Iraq and Afghanistan, the DoD has sometimes struggled to provide child care for their children. And force reductions and budget cuts are likely to force the military to make difficult choices as it seeks to streamline its child-care services in the years ahead. PMID:25518693
Phillips, D; Adams, G
Studies of child development confirm that experiences with people mold an infant's mind and personality. Caregiving is, therefore, central to development, whether the caregiver is a parent, a grandmother, or a teacher in a child care center. This article uses data from new, national studies of families to examine the state of child care for infants and toddlers. The story it tells is complex, as the authors outline the overlapping impacts that diverse child care settings and home situations have on children. Early exposure to child care can foster children's learning and enhance their lives, or it can leave them at risk for troubled relationships. The outcome that results depends largely on the quality of the child care setting. Responsive caregivers who surround children with language, warmth, and chances to learn are the key to good outcomes. Other quality attributes (like training and staff-to-child ratios) matter because they foster positive caregiving. Diversity and variability are hallmarks of the American child care supply. Both "wonderful and woeful" care can be found in all types of child care but, overall, settings where quality is compromised are distressingly common. Children whose families are not buoyed by good incomes or government supports are the group most often exposed to poor-quality care. Given this balanced but troubling look at the status of child care for infants and toddlers, the authors conclude that there is a mismatch between the rhetoric of parental choice and the realities facing parents of young children in the United States. They call on communities, businesses, foundations, and government to play a larger role in helping parents secure good care for their infants and toddlers. PMID:11712454
... MANAGEMENT 45 CFR Part 800 RIN 3206-AM47 Patient Protection and Affordable Care Act; Establishment of the..., entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for... defined in section 1402(b) of the Affordable Care Act.'' 8. On Web page 15568, in the third column,...
... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... intent to award Affordable Care Act (ACA) appropriations to the following 7 grantees: Colorado, Iowa.... Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section 4002 [42 U.S.C....
Ortega, Alexander N.; Rodriguez, Hector P.; Bustamante, Arturo Vargas
The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers. PMID:25581154
Ohio Historical Society, Columbus.
This is the second in a series of three reports addressing issues, problems, and potential solutions critical to the development of accessible, affordable, and quality day care in Oregon. At present, the majority of Oregon households have two or more wage earners, and the majority of Oregon children need child care on a daily basis. Priority…
Brown, Cynthia G.; Cooper, Donna; Herman, Juliana; Lazarín, Melissa; Linden, Michael; Post, Sasha; Tanden, Neera
This issue brief presents a plan to expand educational opportunities and care for children ages 0-5 years old by investing significant federal dollars to: (1) Make high-quality preschool universally accessible to all 3- and 4-year-old children; and (2) Enable more lower-income families to afford child care for children ages 0-3 years old. These…
Michigan State Univ., East Lansing.
This Kids Count status report profiles the status of child care and early childhood education in Michigan. The first part of the report examines the growing need for child care, and examines three main issues; availability, affordability, and quality. The second part of the report examines these issues as they pertain to the state of Michigan.…
Corbett, Franklin, Jr.
This group facilitator manual which forms the basis of a package of materials (including a handbook and media presentation) is designed for use with child care councils, policy advisory committees, and child advocacy groups which want to become more effective in developing programs for children. The manual is divided into two major sections. The…
Child Care Bureau, 2003
This monograph highlights and compares approaches of six demonstration grant projects designed to promote collaboration between state Child Support Enforcement, Child Care, and Head Start programs. These demonstration grant projects were awarded to Alaska, Connecticut, Illinois, Maryland, Minnesota, and Missouri. These three-year projects were…
Ahuja, Abba; Sharma, Neeta; Tiwari, Shashi
Examined the preferences of mothers from two rural villages in India for existing child care arrangements in comparison with community child care and the community's opinions regarding child care arrangements or practices. Found that the most popular child care arrangement was using grandparents as caregivers, followed by community child care…
... 7 Agriculture 4 2014-01-01 2014-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...
... 7 Agriculture 4 2013-01-01 2013-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...
... 7 Agriculture 4 2010-01-01 2010-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...
... 7 Agriculture 4 2012-01-01 2012-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...
... 7 Agriculture 4 2011-01-01 2011-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...
Ryan, Rebecca M.; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne
In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government’s largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the quality of care families purchase. This study investigates the impact of government subsidization on parents’ selection of child care quality using multivariate regression and propensity score matching approaches to account for differential selection into subsidy receipt and care arrangements. Data were drawn from the Child Care Supplement to the Fragile Families and Child Wellbeing Study (CCS-FFCWS), conducted in 2002 and 2003 in 14 of the 20 FFCWS cities when focal children were 3 years old (N = 456). Our results indicate that families who used subsidies chose higher quality care than comparable mothers who did not use subsidies, but only because subsidy recipients were more likely to use center-based care. Subgroup analyses revealed that families using subsidies purchased higher-quality home-based care but lower-quality center-based care than comparable non-recipients. Findings suggest that child care subsidies may serve as more than a work support for low-income families by enhancing the quality of nonmaternal care children experience but that this effect is largely attributable to recipients’ using formal child care arrangements (versus kith and kin care) more often than non-recipients. PMID:21874092
Ryan, Rebecca M; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne
In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government's largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the quality of care families purchase. This study investigates the impact of government subsidization on parents' selection of child care quality using multivariate regression and propensity score matching approaches to account for differential selection into subsidy receipt and care arrangements. Data were drawn from the Child Care Supplement to the Fragile Families and Child Wellbeing Study (CCS-FFCWS), conducted in 2002 and 2003 in 14 of the 20 FFCWS cities when focal children were 3 years old (N = 456). Our results indicate that families who used subsidies chose higher quality care than comparable mothers who did not use subsidies, but only because subsidy recipients were more likely to use center-based care. Subgroup analyses revealed that families using subsidies purchased higher-quality home-based care but lower-quality center-based care than comparable non-recipients. Findings suggest that child care subsidies may serve as more than a work support for low-income families by enhancing the quality of nonmaternal care children experience but that this effect is largely attributable to recipients' using formal child care arrangements (versus kith and kin care) more often than non-recipients. PMID:21874092
Grogan, Colleen M
This introductory essay to JHPPL's special issue on accountable care organizations (ACOs) presents the broader themes addressed in the issue, including (1) a central tension between cooperation versus competition in health care markets with regard to how to bring about improved quality, lower costs, and better access; (2) US regulatory policy - whether it will be able to achieve the appropriate balance in health care markets under which ACOs could realize expected outcomes; and (3) ACO realities - whether ACOs will be able to overcome or further embed existing inequities in US health care markets. PMID:26574482
Hale, Cynthia M.; Polder, Jacquelyn A.
Recognizing the importance of maintaining a safe and healthy child care setting, this manual for home or center child care providers contains information and guidelines to help providers maintain child health and reduce sickness and injuries. Part 1, "Introduction," describes how diseases are spread and how to prevent and prepare for unintentional…
Using a longitudinal dataset collected by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network, this paper investigates the association between work schedules and child care decisions among mothers with children under 3 years of age. Separate analyses were conducted on a sample of married mothers…
Rieselbach, Richard E.; Feldstein, David A.; Lee, Patrick T.; Nasca, Thomas J.; Rockey, Paul H.; Steinmann, Alwin F.; Stone, Valerie E.
Background Although primary care general internists (PCGIs) are essential to the physician workforce and the success of the Affordable Care Act, they are becoming an endangered species. Objective We describe an expanded program to educate PCGIs to meet the needs of a reformed health care system and detail the competencies PCGIs will need for their roles in team-based care. Intervention We recommended 5 initiatives to stabilize and expand the PCGI workforce: (1) caring for a defined patient population, (2) leading and serving as members of multidisciplinary health care teams, (3) participating in a medical neighborhood, (4) improving capacity for serving complex patients in group practices and accountable care organizations, and (5) finding an academic role for PCGIs, including clinical, population health, and health services research. A revamped approach to PCGI education based in teaching health centers formed by community health center and academic medical center partnerships would facilitate these curricular innovations. Anticipated Outcomes New approaches to primary care education would include multispecialty group practices facilitated by electronic consultation and clinical decision-support systems provided by the academic medical center partner. Multiprofessional and multidisciplinary education would prepare PCGI trainees with relevant skills for 21st century practice. The centers would also serve as sites for state and federal Medicaid graduate medical education (GME) expansion funding, making this funding more accountable to national health workforce priorities. Conclusions The proposed innovative approach to PCGI training would provide an innovative educational environment, enhance general internist recruitment, provide team-based care for underserved patients, and ensure accountability of GME funds. PMID:24949177
Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M
The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts. PMID:26845492
The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA. PMID:27127261
The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency. PMID:23262767
ABRAHAM, JEAN MARIE
Context: The Affordable Care Act (ACA) is predicted to expand health insurance to 25 million individuals. Since insurance reduces the price of medical care, the quantity of services demanded by these newly covered individuals is expected to rise. In this article I provide a comprehensive picture of the demographics, health status, and medical care utilization of the population targeted for the ACA's expansion of coverage, contrasted with that of other nonelderly, insured populations. In addition, I synthesize the current evidence regarding the causal impact of insurance on medical care demand, drawing heavily on recent evidence from Massachusetts and Oregon. Methods: Using the 2008 to 2010 Medical Expenditure Panel Survey, I conducted bivariate and multivariate analyses to examine differences between the ACA target population and other insured groups. I used the results from the descriptive analysis and quasi-experimental literature to generate “back of the envelope” estimates of the potential impact of the coverage expansion on total medical care utilization by the noninstitutionalized US population. Findings: Comparisons of the potential ACA target population with the privately and publicly insured reveal that the former is younger and more likely to be male. The ACA target population, and particularly the uninsured with incomes under 200% of the federal poverty line, reports lower rates of several medical conditions relative to those of the privately and publicly insured. Future changes in rates of inpatient hospitalization and ED use among the newly insured could vary widely, based on descriptive findings and inferences from the quasi-experimental literature. Results also suggest moderate increases in ambulatory care. Total increases in overall demand for medical care by the newly insured comprise a modest proportion of the aggregate utilization. Conclusions: With the expected increases in utilization resulting from the coverage expansion
The U.S. Office of Personnel Management (OPM) is issuing a final rule implementing modifications to the Multi-State Plan (MSP) Program based on the experience of the Program to date. OPM established the MSP Program pursuant to the Affordable Care Act. This rule clarifies the approach used to enforce the applicable standards of the Affordable Care Act with respect to health insurance issuers that contract with OPM to offer MSP options; amends MSP standards related to coverage area, benefits, and certain contracting provisions under section 1334 of the Affordable Care Act; and makes non-substantive technical changes. PMID:25735057
It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) serves a vital role in the delivery of health care to our nation’s students within the health care system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as the Affordable Care Act (ACA). This law presents an opportunity to transform the health care system through three primary goals: expanding access, improving quality, and reducing cost (U.S. Government Printing Office, 2010). School nurses stand at the forefront of this system change and continue to provide evidence-based, quality interventions and preventive care that, according to recent studies, actually save health care dollars (Wang et al., 2014). NASN supports the concept that school nursing services receive the same financial parity as other health care providers to improve overall health outcomes, including insurance reimbursement for services provided to students. PMID:25926418
North Carolina Univ., Chapel Hill. Frank Porter Graham Center.
Described is the child care program at the Frank Porter Graham Center. Discussion of physical facilities focuses on creating a good environment, floor plan of cottage trailer, and choosing appropriate equipment. Selection of staff is said to be the most important part of establishing a day care center. The day care center is explained to serve the…