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Chapter Six: Choosing and Paying for Child Care
All of the families recruited for the study were using some form of family child care when the study began. This chapter examines how and why parents chose their child care provider, as well as what they perceived their options to be. The chapter also examines the cost of care, with and without subsidies, and families’ experience with subsidies. Changes over time are discussed when relevant.
All parents, and especially low-income parents, face constraints on their choice of child care. The kind of care they would like may not be available in their neighborhood, or may cost more than they can pay. In addition, as we saw in the last chapter, parents’ work schedules may make some types of child care inaccessible, because of the hours during which care is needed. Just over 16 percent of families considered a special need of the child, in most cases a chronic health condition or physical disability, in making their decision.
As we noted earlier in the report, at the beginning of the study, more than one-third of the focus children were cared for by a relative in the relative’s home. More than half (57%) had one or more siblings in the same child care arrangement. The remainder of the focus children were in family child care, i.e., cared for by a non-relative in that person’s home. At the end of the study, more than one-third (35%) were being cared for by a relative, a slightly larger percentage (38%) were in family child care homes, 11 percent had moved to a center, 4 percent were in an after-school program and the remaining 12 percent were cared for by a parent or sibling or, in a small number of cases, cared for themselves. Almost two-thirds (64%) had a sibling in the same care arrangement.
By the end of the study, almost half of the focus children were in three or more concurrent arrangements, one-quarter were in two child care arrangements and the remaining quarter were in a single arrangement. Since birth, just over one-quarter (26%) had been in a single care arrangement, another quarter had been in two care arrangements, and almost half had been in three or more arrangements.1 Almost two-thirds (64%) of White children had experienced three or more care arrangements since birth, compared with 43 percent of Black children and 46 percent of Hispanic children (Exhibit 6-1). Children cared for by relatives had a more stable child care history than those cared for by non-relatives. Almost 40 percent of the children cared for by a relative at the time of the last interview had been in a single care arrangement since they were born, compared with 19 percent of children in non-relative (including center) care (Exhibit 6-2).
| White/ Non-Hispanic % |
Black/ Non-Hispanic % |
Hispanic % |
Other % |
All Children % |
|
|---|---|---|---|---|---|
| Single care arrangement | 15 | 31 | 25 | 31 | 26 |
| Two care arrangements | 21 | 26 | 29 | 16 | 25 |
| Three or more care arrangements | 64 | 43 | 46 | 53 | 49 |
| Sample size | 146 | 306 | 111 | 36 | 599 |
| Source: Last Parent Interview |
| Relative Care % |
Non-Relative Care % |
All Children in Non-Parental Care % |
|
|---|---|---|---|
| Single care arrangement | 39 | 19 | 27 |
| Two care arrangements | 22 | 25 | 24 |
| Three or more care arrangements | 39 | 55 | 49 |
| Sample sizea | 213 | 319 | 532 |
| Source: Last Parent Interview a Sample is only children in non-parental care and excludes 67 children in parental or sibling care at the last interview. |
Finding Child Care
Just over half (52%) of the parents considered other arrangements for their child before making their decision, visiting other providers or child care facilities or thinking about staying home to care for the child themselves. Almost one-third (31%) had no alternative to the arrangement they chose. However, lack of choice did not always translate into dissatisfaction with their arrangement; less than 10 percent of the parents would have preferred a different arrangement. About half of those who would have preferred a different arrangement would have opted for an unrelated family child care provider; almost one-third would have liked center care for their child. The remainder would have preferred care by a grandparent or other relative, or to stay home to care for the child themselves.
Of the parents who felt they had other possible choices, 43 percent had a single alternative arrangement, 40 percent had two alternatives and the remainder had three or more alternatives to the arrangement they chose. Most frequently, the alternatives were other family child care homes or care by a relative, although 43 percent of parents said that center care was an option open to them.
Where Do Parents Get Their Information About Child Care?
The extent to which parents know about possible alternative care arrangements may be influenced by where they get their information about child care. Families that are receiving cash assistance may be offered help in finding care by the welfare agency or another community agency. Similarly, families that receive a child care subsidy can get help in finding care from the subsidy agency or a resource and referral agency. Of the two-thirds of families that used non-relative care, 30 percent learned about their provider from a public or private agency; the majority were referred by a friend, neighbor, family member or another child care provider (42%) or knew the provider already (24%).2 A handful of families found their provider through an ad in a newspaper or a bulletin board, or in the Yellow Pages. The overwhelming majority (92%) visited the provider to see where and how the child would be cared for before they made their decision.
On average, it took parents about a month to make the final arrangement. However, there was wide variation in the amount of time it took; for 41 percent of families it took less than a day to make the arrangement, while for a small number of families (less than 5%) it took more than six months (Exhibit 6-3).
| 0 to 35 Months % |
36 to 59 Months % |
Over 59 Months % |
All Parents % |
|
|---|---|---|---|---|
| Less than 1 day | 40.2 | 36.5 | 44.3 | 40.7 |
| 1 – 7 days | 7.4 | 9.4 | 7.7 | 8.1 |
| 1 – 4 weeks | 25.4 | 33.2 | 34.7 | 27.4 |
| 1 – 6 months | 23.8 | 15.5 | 18.7 | 19.3 |
| 6 – 12 months | 2.1 | 2.2 | 2.6 | 2.3 |
| A year or more | 1.1 | 3.3 | 2.1 | 2.2 |
| Sample size | 205 | 192 | 243 | 642 |
| Source: Parent Interview |
Knowledge of the Child Care Market
How informed are parents’ choices of child care arrangements? As we demonstrated in the preceding section, the referral to their current provider came primarily from friends, relatives or neighbors, or as a consequence of their own acquaintance with the provider. We asked parents a series of questions about the availability of different types of care in their neighborhood for children of different ages.
Parents were asked about the child care options available in their neighborhood for parents with infants, toddlers and preschool–age children. Then they were asked what type of care parents in their neighborhood typically choose for children of different ages. Many parents found these questions difficult to answer, especially for children older or younger than their own child, so that for each question, a substantial number of parents responded “Don’t know”.
For children of all ages, few parents reported that care in a child’s own home by either a relative or an unrelated adult was an available option. This type of care was seen as hardest to find for school-age children; only 11 percent and 9 percent of parents believed that care in the child’s home by a non-relative or a relative was a possibility, compared with 15 percent and 18 percent who believed this type of care was available for toddlers or preschoolers. Indeed parents perceived that there was less availability of most types of care for school-age children compared with their availability for younger children. Care by relatives or care in a school-based after-school program were the most often cited options for school-age children, while center care was seen as the type of care most available for toddlers and preschoolers. Center care and family child care were seen as equally available for infants (Exhibits 6-4, 6-5 and 6-6).
| Yes % |
No % |
Don’t Know % |
|
|---|---|---|---|
| Center care | 40.2 | 19.2 | 40.7 |
| Care by a non-relative in person’s home | 39.9 | 18.4 | 41.7 |
| Care by relative in relative’s home | 36.5 | 18.7 | 44.8 |
| Care by a non-relative in child’s home | 13.7 | 28.7 | 47.6 |
| Care by relative in child’s home | 17.0 | 35.2 | 47.8 |
| Sample size = (n = 642 ) |
| Source: Parent Interview |
| Yes % |
No % |
Don’t Know % |
|
|---|---|---|---|
| Center care | 58.2 | 10.3 | 31.5 |
| Care by a non-relative in person’s home | 46.9 | 18.6 | 34.5 |
| Care by relative in the relative’s home | 35.9 | 25.3 | 38.7 |
| Care by a non-relative in child’s home | 15.0 | 44.6 | 40.4 |
| Care by relative in child’s home | 18.3 | 40.5 | 41.2 |
| Sample size (n = 642) |
| Source: Parent Interview |
| Yes % |
No % |
Don’t Know % |
|
|---|---|---|---|
| School-based programs | 38.4 | 23.9 | 37.6 |
| Non-school-based programs | 29.3 | 32.1 | 38.6 |
| Center care | 33.1 | 28.7 | 38.2 |
| Care by a non-relative in person’s home | 32.7 | 28.6 | 38.7 |
| Care by relative in relative’s home | 39.3 | 30.4 | 40.4 |
| Care by a non-relative in child’s home | 11.3 | 46.7 | 42.1 |
| Care by relative in child’s home | 8.8 | 49.5 | 41.7 |
| Sample size (n = 642) |
| Source: Parent Interview |
When asked what type of care parents in their neighborhood normally choose for their children, parents’ responses differed depending on the child’s age. For infants, the two types of care that parents reported most frequently used were care by a relative in the relative’s home (26%) or family child care (22%). For toddlers and preschoolers, almost one-third (31%) reported center care as the “normally chosen” mode of care, while, for school-age children, parents reported them as scattered almost equally across four or five different types of care outside the home (Exhibit 6-7). Parents of infants were less likely to know about child care options than parents of older children.
| Infants % |
Toddler/ Preschoolers % |
School-age % |
|
|---|---|---|---|
| School-based after-school programs | NA | NA | 19 |
| Non-school-based after-school programs | NA | NA | 9 |
| Center care | 15 | 31 | 15 |
| Care by a non-relative in that person’s home | 22 | 20 | 14 |
| Care by relative in the relative’s home | 26 | 18 | 14 |
| Care by a non-relative in the child’s home | 2 | 2 | 4 |
| Care by relative in the child’s home | 6 | 6 | 4 |
| Don’t Know | 28 | 23 | 20 |
| Sample size (n = 642) |
| Source: Parent Interview |
Reasons for Choosing Child Care Arrangements
Parents were asked the most important reason for the choice of their current child care provider, as well as any other reasons for the choice. Other studies have found that, regardless of the type of care chosen, safety considerations play a key role. However, parents who choose center care perceive safety in a structured, monitored environment; for parents who use informal care, safety is assured because the provider is someone they personally know and trust (Butler et al., 1991; Galinsky et al., 1994; Hofferth et al., 1991).
No single reason dominated parents’ choices, but safety was the prime consideration for almost one-quarter (24%) of the parents, and one of several factors for 60 percent of them. Almost equally important were practical considerations such as accessibility and hours that match the parent’s schedules (22%), and the parent’s relationship with and feelings about the child care provider (20%). Aspects of the care arrangement that might be related to school readiness were rarely given as the most important reasons for parents’ choice and less than 20 percent of parents mentioned these considerations at all (Exhibit 6-8). We expected that different considerations would apply for children of different ages, but this did not turn out to be the case. Across families with children of different ages and different ethnicities, reasons for choosing a care arrangement differed little if at all. For families that used relative care, the parent’s relationship with the provider was the dominant reason for parents’ choice. This finding echoes findings from earlier studies in which parents who use relative care stress the importance of family bonds and a trusting relationship (Galinsky et al., 1994; Hofferth et al., 1991; Zinsser, 1991).
Attitudes Toward and Beliefs about the Child Care Arrangement
Parents were asked to rate the relative importance to them of different aspects of the care arrangement. Not surprisingly, given their reasons for choosing the care arrangements, the safety and cleanliness of the home was of paramount importance to them. For almost all (96%) the parents, the provider’s experience in taking care of children was extremely or very important compared with 70 percent who felt that licensing was extremely or very important. How the caregiver disciplines children and her warmth towards the children were seen as more important than her teaching of cultural or religious values. Almost all (97%) felt that it was extremely or very important that the provider teach children to get along with other children. More than two-thirds (71%) of parents saw teaching things the child needs to know for school as extremely or very important, and just under two-thirds (61%) expressed concern about the amount of TV or videos that children are allowed to watch (Exhibit 6-9).
Parents were asked open-ended questions about what they saw as the advantages and disadvantages of a family child care arrangement. Over two-thirds of the parents (68%) perceived no disadvantages to family child care. Parents who were using relative care were more likely to give this response than parents who were using an unrelated family child care provider (77% vs. 63%). Eleven percent of the parents pointed out that the inability of the provider to arrange for a back-up care arrangement is a disadvantage; parents using a non-relative were more than twice as likely as those using a relative caregiver to cite this as a disadvantage (14% vs. 6%) (Exhibit 6-10).
| Most Important Reason % | Any Mention % | ||
|---|---|---|---|
| Cost | 18.1 | 41.1 | |
| Cost | 9.7 | 13.9 | |
| Provider accepts subsidy | 8.4 | 14.4 | |
| Parent Needs | 21.7 | 61.0 | |
| Availability of care | 5.6 | 13.9 | |
| Convenient hours | 6.5 | 18.1 | |
| Convenient location | 9.2 | 31.6 | |
| Provider provides transportation | 0.5 | 0 | |
| Provider will care for siblings | 0.6 | 6.8 | |
| Safety | 23.5 | 60.2 | |
| Provider is trustworthy | 10.0 | 20.9 | |
| Recommended by someone I trust | 4.8 | 5.3 | |
| Safety/health/cleanliness | 8.4 | 32.2 | |
| Provider Qualities | 14.8 | 63.4 | |
| Attention/warmth towards children | 7.2 | 30.9 | |
| Child is comfortable with her | 2.1 | 10.0 | |
| Experience in caring for children | 2.3 | 9.5 | |
| Home-like atmosphere | 2.9 | 12.9 | |
| Provider is trained, professional | 1.0 | 5.0 | |
| Child Development | 2.3 | 13.5 | |
| Children of different ages | 0.0 | 2.8 | |
| Prepares child for school | 1.3 | 4.9 | |
| Number of children | 1.3 | 6.1 | |
| Relationship with Provider | 20.0 | 43.5 | |
| Prefer family member | 14.1 | 11.7 | |
| Provider has same values | 2.1 | 9.1 | |
| Provider like a family member | 2.7 | 8.3 | |
| Relationship to parents | 1.1 | 5.7 | |
| Same language/ethnicity | 0.2 | 0.8 | |
| Sample size (n = 642 parents) | |||
| Sources: Parent Interview |
| Extremely Important % |
Very Important % |
Somewhat Important % |
Not too Important % |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Provider experience | meana = 4.2 | ||||||||||||
| Provider licensed or registered by the state | 36.4 | 33.3 | 13.5 | 16.8 | |||||||||
| Provider experienced in caring for children | 54.3 | 41.7 | 3.4 | 0.6 | |||||||||
| Provider trained in caring for children | 45.8 | 45.0 | 7.5 | 1.8 | |||||||||
| Amount of provider experience in child care. | 35.9 | 48.4 | 12.4 | 3.3 | |||||||||
| Provider values | mean = 4.2 | ||||||||||||
| Teaches cultural/religious values | 16.8 | 25.2 | 26.2 | 31.8 | |||||||||
| Style of discipline | 63.8 | 31.0 | 4.6 | 0.8 | |||||||||
| Provider shares parent’s values | 38.3 | 46.4 | 12.5 | 2.8 | |||||||||
| Attention children receive from provider | 54.6 | 43.9 | 1.5 | 0 | |||||||||
| Provider warmth toward children | 54.1 | 43.1 | 2.8 | 0 | |||||||||
| Provider relationship to parent and child | mean = 4.3 | ||||||||||||
| Provider’s openness to parents dropping in | 62.1 | 30.6 | 5.2 | 2.1 | |||||||||
| Provider communication with parents | 60.6 | 36.5 | 2.1 | 0.8 | |||||||||
| Close relationship of provider with family | 29.6 | 29.7 | 24.8 | 15.9 | |||||||||
| Care that is day in and day out | 58.0 | 35.4 | 6.2 | 0.5 | |||||||||
| Safety and cleanliness of home | mean = 4.6 | ||||||||||||
| Cleanliness | 63.2 | 34.5 | 2.1 | 0.2 | |||||||||
| Attention to nutrition | 51.9 | 43.1 | 4.4 | 0.7 | |||||||||
| Attention to safety | 79.9 | 19.8 | 0.3 | 0 | |||||||||
| Other children in care | mean = 3.3 | ||||||||||||
| Number of children | 20.4 | 35.5 | 30.9 | 13.2 | |||||||||
| Different aged children | 10.9 | 27.5 | 39.1 | 22.5 | |||||||||
| Children from different ethnic groups | 15.2 | 22.8 | 32.8 | 29.2 | |||||||||
| Activities in home | mean = 3.8 | ||||||||||||
| Children taught to get along with each children | 45.9 | 51.4 | 1.9 | 0.8 | |||||||||
| Children taught things needed for school | 32.6 | 38.5 | 24.8 | 4.1 | |||||||||
| Children taught about their community | 12.5 | 28.2 | 42.1 | 17.2 | |||||||||
| Children taught about nature | 13.5 | 26.8 | 45.6 | 14.1 | |||||||||
| Amount of TV/videos children can watch | 22.2 | 38.4 | 28.3 | 11.1 | |||||||||
| Opportunities for active play | 31.9 | 49.6 | 16.8 | 1.8 | |||||||||
| Provider has organized activities | 19.2 | 52.2 | 23.9 | 4.7 | |||||||||
| Sample size (n = 642 parents) | |||||||||||||
| Sources: Parent Interview a Mean score refers to average score across items (1 to 4 where 1 = Not too important). |
| Disadvantages | Relative Care % |
Non-Relative Care % |
All Parents % |
|---|---|---|---|
| No disadvantages | 77.4 | 63.4 | 68.1 |
| No back up if provider is sick | 5.9 | 14.4 | 11.3 |
| Provider doesn't teach child | 2.3 | 5.9 | 4.6 |
| Too few children | 5.0 | 3.1 | 3.8 |
| Not enough toys or equipment | 1.4 | 4.9 | 3.6 |
| Provider is alone, nobody sees what she is doing | 1.4 | 3.9 | 2.9 |
| Not enough structure | 3.2 | 2.1 | 2.5 |
| Hours not flexible enough | 0.9 | 2.8 | 2.1 |
| Provider does chores during care | 0.9 | 2.3 | 1.8 |
| Too much TV | 0.9 | 2.1 | 1.6 |
| Problems mixing personal and business | 1.8 | 1.6 | 1.6 |
| Provider tells parent how to raise children | 2.3 | 0.8 | 1.3 |
| Provider has too many visitors | 0.0 | 0.8 | 0.5 |
| Provider's children have too many playmates over | 0.5 | 0.3 | 0.3 |
| Sample size | 231 | 411 | 612 |
| Sources: Parent Interview |
Almost half of the parents (48%) felt that the individual attention children receive in family child care was an advantage, although, interestingly, this was more frequently mentioned by families using an unrelated provider than by families using a relative (53% vs. 39%). The home environment and the flexibility and appropriateness of the hours that care can be provided were the next most frequently mentioned advantages of this type of care. A small percentage (9%) of parents saw no advantages and would prefer center care (Exhibit 6-11). This is a smaller percentage than has been found in some earlier research (Hofferth et al., 1995 in Phillips and Budgman, 1995).
These questions were not repeated routinely over the course of the study3, but they were asked again as part of the last interview with parents. Parents’ views of what was important and what were the advantages and disadvantages of their current arrangement varied hardly at all over time. An even smaller fraction of parents, just over one-quarter, perceived any disadvantages in their care arrangement. Those parents who had moved to center care or an after-school program for their child saw no disadvantages to the arrangement.
| Relative Care % |
Non-Relative Care % |
All Parents % |
|
|---|---|---|---|
| More individual attention | 39.4 | 53.2 | 48.2 |
| Like a home | 27.6 | 33.8 | 31.5 |
| Flexibility of hours | 31.8 | 25.3 | 27.6 |
| Hours of care match parent’s schedule | 18.6 | 27.1 | 24.0 |
| Cost | 20.4 | 23.8 | 22.6 |
| Care is close to home/work | 14.9 | 22.8 | 19.9 |
| Child can be with siblings | 19.9 | 19.4 | 19.6 |
| Provider shares my values | 14.5 | 19.7 | 17.8 |
| Provider like/is family member | 16.3 | 17.4 | 17.0 |
| Provider helps parent and child | 19.5 | 8.7 | 12.6 |
| Better safety/health | 16.7 | 6.1 | 10.0 |
| Know or trust provider | 14.9 | 3.8 | 7.8 |
| Home has children with different ages | 3.2 | 8.2 | 6.4 |
| Cares for infants | 2.7 | 5.4 | 4.4 |
| Good learning experiences | 1.4 | 4.6 | 3.4 |
| Consistency of caregiver | 1.4 | 3.3 | 2.6 |
| General flexibility | 3.6 | 0.8 | 1.8 |
| No advantages, would prefer center | 5.4 | 11.0 | 9.0 |
| Sample size | 231 | 411 | 642 |
| Sources: Parent Interview |
Paying for Child Care
Although the majority of families in this sample were receiving a child care subsidy at the time of the first interview, only 22 percent paid nothing for their child care. We asked mothers to tell us their out-of-pocket costs for child care for the month prior to the interview and the number of children paid for. The average monthly payment for child care was $121.17; the average per child payment was $81.03. Parents who were receiving subsidies paid, on average, less than half of the amount paid by those who were not receiving subsidies (Exhibit 6-12).
| No Subsidy | Receives Subsidy | All Families | |
|---|---|---|---|
| Mean | Mean | Mean | |
| Out-of-pocket monthly payment for all children | $226.50 | $93.33 | $121.17 |
| Out-of-pocket per-child payment | $168.33 | $57.65 | $81.00 |
| Sample size | 131 | 478 | 609 |
| Source: Parent Interview |
For 80 percent of the parents who were receiving subsidies, the monthly payment represented the required copayment; 10 percent had no copayment.4 For the 9 percent whose monthly payment was not the same as the required copayment, about half paid more than the copayment and half paid less. While states require a copayment from most or all of the families that receive subsidies, they usually do not monitor the payment and act only if the provider lodges a complaint. In many states, providers may legally charge more than the subsidy reimbursement rates but are responsible for collecting the additional amount.
Experience with Subsidies
As we noted earlier in the report, 80 percent of the families in this sample were receiving a child care subsidy at the time they were recruited. Of the remaining 20 percent, more than one-third had applied for a subsidy in the past and half of these had received a subsidy. The main reason given for loss of subsidy was that the child who was receiving the subsidy became ineligible5 (at this point, we are talking about a handful of families [n=27] in this group). For all but 6 percent of families who received subsidies, their child care arrangement did not change when they received a subsidy and, for the small group who had a subsidy and then lost it, child care arrangements did not change for most when the subsidy ended.
The most common source of information about subsidies was a friend or relative (36%) or the welfare agency (35%). Another 13 percent heard about subsidies from a child care resource and referral agency. Child care centers are often a source of information about subsidies; however, for parents in this sample, only 10 percent heard about subsidies from their family child care provider. Least often mentioned sources of information were employers (3%) and child care agency staff (4%).
Summary of Findings
-
Child care arrangements had been stable for many of the focus children in the study; by the end of the study, half of them had had two or fewer different arrangements since birth. Children cared for by relatives had a more stable child care history than those cared for by non-relatives. Almost 40 percent of the children cared for by a relative at the time of the last interview had been in a single care arrangement since they were born, compared with 19 percent of children in non-relative (including center) care.
-
Two-thirds of parents felt they had alternatives to the child care arrangement they chose; less than 10 percent would have preferred a different arrangement. It took parents about a month on average to make the child care arrangement, most often on the basis of information or advice from a friend, neighbor or relative.
-
Parents seemed to have an accurate assessment of the availability of child care in their community, perceiving options for school-age children as scarce and center-based programs as more available for toddlers and preschoolers.
-
Safety, practical considerations such as hours that match work schedules and the location of the provider, and the parent’s positive relationship with the provider were the major reasons given for choosing the care arrangement.
-
Subsidies made child care considerably more affordable for families; those who were receiving subsidies paid, on average, less than half of the amount paid by families who bore the whole cost of care themselves. Contrary to what we might have anticipated, for the most part, parents did not change their child care arrangements when they began receiving subsidies or when they lost the subsidy.
1 Children who were cared for by relatives probably increased the average stability of the care arrangement. (back)
2 All of the communities had active Child Care Resource and Referral Agencies. (back)
3 Those parents who changed care arrangements were asked about the reasons for the change. (back)
4 Frequently parents who receive a subsidy are required to make a copayment to the provider. However, many states do not require a copayment for parents who are receiving TANF cash assistance. In addition, even if a copayment is required, the provider may opt not to collect it. (back)
5 The child probably “aged out” (i.e., turned 13). (back)
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