I 
I 
Department  of Health  and  Human  Services 
OFFICE  OF
II 
I  INSPECTOR  GENERAL 
THE  AT-RISK  CHILD  CARE  PROGRAM 
AUGUST  1993  OFFICE  OF  INSPECTOR  GENERAL 
The mission of the Office of Inspector Gcncrti] (OIG). as mandated by Public Law 95-452,  as 
anwndcd.  is to protec[ the integri~y of the Dcpannlen(  of Health and Human Senices  (HHS) 
progratws as well as the health and welfare of beneficiaries  served by those programs.  This 
s[a[uton  mission  is carried  of audi[s, investigations.  and 
m;  through  a  nationwide  network 
inspcctiom  conducuxi by [hree OIG operating components:  the Office of Audit Services,  the 
Office of investigations,  and the Office of Evaluation  and inspections.  The OIG also inforrm  the 
Sccre[ary of I{HS of program  ~nd managcmcn[ prob]ems and recommends  courses [o correct  them. 
OFFICE  OF  AUDIT  SERVICES 
The OIGS Office of Audit Services (OAS) provides  all auditing  ser~ices for HHS, either by 
conducting  audits with its own audit resources or by overseeing  audit work done by others.  Audits 
examine the performance  of HHS programs  and/or  its grantees and centractors in carrying  OU[ 
their respective  responsibilities  and are intended (o provide  independent assessments  of HHS 
programs  and operations  in order to reduce waste, abuse.  and mismanagement  and to promote 
economy and efficiency throughout  the Department. 
OFFICE  OF  INVESTIGATIONS 
The OIGS Office of Investigations  (01) conducts criminal,  civil, and administrative  investigations

of allegations  of wrongdoing  in HHS programs  or to HHS beneficiaries  and of unjust enrichment

by providers.  The investigative  efforts of 01 lead to criminal  convictions.  administrative

sanctions,  or civil money penalties.  The 01 also oversees  State Medicaid fraud control units which

investigate and prosecute  fraud and patient abuse in the Medicaid program.

OFFICE  OF  EVALUATION  AND  INSPECTIONS 
The OIGS Office of Evaluation  and Inspections (OEI) conducts short-term  management  and

program  evaluations  (called inspections)  that focus on issues of concern to the Department,  the

Congress,  and the public.  The findings and recommendations  contained  in these inspection  reports

generate  rapid,  accurate,  and up-to-date  information  on the efficiency,  vulnerability,  and

effectiveness of departmental  programs.  This report was prepared  in the New York regional office

under the direct ion of Thomas  F. Tull y, Regional Inspector  General and Alan S. Meyer,  Deputy

Regional Inspector  General.  Project  staff

REGION  II  HEADQUARTERS

Joseph J. Corso,  Jr.,  Project  Leader  Ruth FoIchrnan

Joseph M. Benkoski

Demetra Arapakos

Lucille M. Cop

For additional  copies of this report,  contact the New York regional office at 212/244-1998.
 Department  of Health  and  Human  Services 
OFFICE  OF 
INSPECTOR  GENERAL 
THE  AT-RISK  CH  LD  CARE  PROGRAM 
AUGUST  1993  OEI-02-92-O0140  EXECUTIVE  SUMMARY 
P1RPOSE 
To du[cmlinc  the extent  and  nature  of  States  participation  in the At-Risk  Child  Care 
program  and  to describe  their  problems  and  successes  with  it. 
13.4CKGROUND 
The At-Risk  Child  Care  program  pro~ides child  care  services  for  children  (usually  under 
age  13) of low-income  working  families  not  receiving  Aid  to  Families  with  Dependent 
Children  (AFDC).  who  need  child care  in order  to accept or maintain  employment,  and 
who would othervise be at risk of becoming  eligible  for AFDC. 
The program  was enac[ed  in November  1990. but was made effective  October  1,  1990. 
Final regulations  give States considerable  latitude  in implementation.  For example.  they 
can define  low income  and  at risk.   Their  participation  is optional. 
This program  is one of several  overseen  and funded by the Administration  for Families 
and Children  (ACF)  in the Department  of Health  and Human  Services  (HHS).  The other 
child care programs  include  AFDC  Child Care,  Transitional  Child  Care,  the Child  Care 
and Development  Block Grant  and a portion  of the Social Services  Block Grant used for 
child care.  Funding  for the At-Risk program  was $300 million  in each of Fiscal  Years 
(FY)  1991 and  1992, and represented  15 percent  of the $2.1 billion  in total HHS funding 
for child care programs  in FY  1992.  The ACF has encouraged  States to coordinate  all the 
funding streams  for child care  so as to provide  seamless  service  to families.  This 
means providing  eligible  parents  access to and payment  for child care  services  and 
programs  which respond  to parents  child care needs,  even as eligibility  changes  over 
time;  services  are provided  without  the necessity  of changing  the child care provider. 
METHODOLOGY 
We selected  a purposive  sample  of 16 States:  12 drawn from those 45 with approved  At-
Risk State plans and with At-Risk  Child  Care expenditures  qualifying  for !lmding  in FYs 
1991 and  1992; two from three  with approved  State plans but with no expenditures 
qualifying  for funding;  and two of three  which did not submit  State plans for approval. 
We then selected  respondents  purposively  and interviewed  them by phone.  They  included 
State officials,  local agency  representatives,  child care providers,  and representatives  of 
advocacy  groups.  We analyzed,  both qualitatively  and quantitatively,  State and local 
documents  and records  and key interview  responses  by all respondent  groups. 
i  DESPITE  SLO\V  START,  3!OST  SA31PLE  STATES  !YO\Y EXPECT  TO  NIAKE 
FULL  USE  OF  AVAILABLE  AT-RISK  CHILD  CARE  FUNDS 
Seven of the  13 sample  States with At-Risk  child  Care  programs  drew down  I%dcral 
funds in FY  1991.  The number  increased  to  12 of  13 in FY  1992. and all but 2 States 
report  serving  more children  in FY  1992 than  in FY  1991.  States initiated  or increased 
[heir spending  in FY  1992 primarily  because  their  legislatures  made initial or additional 
matching  funds available.  Twelve  of the sample  States with At-Risk programs  expect  to 
qualify  for all available  Federal  funds in FY  1993. 
STATES  REPORT  TARGETING  FARIILIES  hlOST  AT  RISK  OF  GOING  ON 
JYELFARE 
The  13 sample  States with At-Risk programs  have set a wide range  of income  eligibility 
scales for the At-Risk Child  Care  program,  with ceilings  for a family of four ranging  from 
$17,982  to $40,491.  However.  States believe  they are serving  the families  in greatest 
need of child care.  In all  13 States,  respondents  estimate  that most of the families  actually 
receiving  services  have annual  incomes  between  $10,000  and $15,000. 
STATES  ARE  COORDINATING  THE  AT-RISK  CHILD  CARE  PROGRAM  WITH 
OTHER  SUBSIDIZED  CHILD  CARE  PROGRAMS;  SOME  CONCERNS 
EXPRESSED 
t 
States believe  they are coordinating  the different  child care funding  streams.  However, 
many  State,  local and advocate  respondents  feel that States are accomplishing  this despite 
funding  and statutory  variations  among  Federal  funding  streams  which make them 
fragmented,  inconsistent  and difficult  to administer. 
COMiIIENTS 
We shared  a copy of the draft of this repot-t with ACF and subsequently  met with ACF 
representatives  to discuss  their comments.  All of ACFS comments  were technical  in 
nature,  and corresponding  changes  have been  incorporated  into this final report. 
ii  TABLE  OF  CONTENTS 
PAGE

EXECLTIJE  SU31\lARY

IXTRODUCT1031  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . ...1

FINDINGS  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4

  Despite  slow start,  Statcs~rill  use all At-Risk  funding  . . . . . . . . . . . . . .  . . .  4

.Sta[es  are targeting  fanli]ies m~st at risk  .<...,...  . . . . . . . . . . . . . . . . . .5

  States prcwideseamless  senices  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
 INTRODUCTION 
P[;RPOSE 
To dc[cmlinc  the extent  and nature of States participation  in the At-Risk Child  Care 
program  and to describe  their problems  and successes  with it. 
BACKGROUND 
The At-Risk  Child Care  progrdm  provides  child care  ser~ices  for children  (usually  under 
age  13) of low-income  working  families  not recei~ing Aid to Families  with Dependent 
Children  (AFDC),  who need child care  in order  to accept or maintain  employmem,  and 
who would otherwise  be at risk of becoming  eligible  for AFDC.  States participation  is 
optional. 
Federal  Prosrams  for Child  Care 
The .At-Risk Child Care  program  is one of several  programs  overseen  and funded by the 
Administration  for Families  and Children  (ACF).  Department  of Health  and Human 
Services  (HHS),  to meet the child care  needs of low-income  families.  The other  child 
care  programs  ACF  oversees  include: 
	 the AFDC  Child Care  Prom-am, which supports  current  AFDC  recipients  efforts 
to participate  in approved  education  and training  activities  to help them become 
self-sufficient  and leave welfare.  Funds are also available  to AFDC  recipients  in 
families  who need child care  in order  to accept or maintain  employment: 
	 the Transitional  Child  Care  t-n-ocram, which provides  up to 12 months  of child care 
for recipients  who leave AFDC  due to increased  income  from employment  or the 
loss of income disregards  due to established  time  limitations; 
	 the Child Care  and Development  Block Grant m-o~ram, which funds efforts  to 
increase  the availability,  affordability  and quality  of child care,  and provides 
additional  funding  for child care  services;  and 
	 the Social Services  Block Grant pro~ram,  which  is intended  to serve a broad  range 
of social service  needs and is used by some States,  in large part,  to provide  child 
care  services. 
Each of these programs  constitutes  a distinct  HHS funding  stream  for child care  services. 
According  to ACF,  in FY  1992 the Child Care  and Development  Block Grant  was funded 
at $825  million  (40 percent);  the exact child care portion  of Social Services  Block Grant 
funding  is unknown  but is estimated  at $510.6  million  (24 percent);  and the AFDC  and 
Transitional  Child  Care programs  at $437.9  million  (21 percent).  The At-Risk  Child  Care 
funding  represented  the smallest  portion  (15 percent)  of the $2.1 billion  in total HHS 
1  funding.  The ACF cstimmcs  owr  $24 billion  in national  spending  for child care  for all 
children  by all sources. 
The AFDC  and Transitional  programs  require  a Staw to usc its funds as a match  for 
Federal  funds at the States Fcdcriil Medical  Assistance  Percentage  rate.  This rate  is 
Mmmined  by formulae  using Dcpartmcm  of Commerce  statistics  for State and national 
pcr capita  income. 
The ACF has encouraged  States to coordinate  all the funding streams  for child care  so as 
to provide  seamless  service  to families.  Basically,  this means providing  eligible  parents 
access to and payment  for child care  services  and programs  which respond  to the parents 
child care  needs,  even as eligibility  changes  over time;  ser~ices are provided  without  the 
necessity  of changing  the child care  provider. 
The At-Risk Child  Care  Program 
Legislation  and Regulations.  The At-Risk Child Care  program  was part  of the omnibus 
Reconciliation  Act of 1990 (OBRA 90).  Section 402(i)  was added to title IV-A of the 
Social Security  Act.  Legislation  was signed in November  1990, but was effective  October 
1. 1990.  The Family  Support  Administration,  ACFs  predecessor,  sent instructions  to 
States on how to apply for At-Risk  Child  Care  funding  in December  1990.  On June 25, 
1991, ACF published  a Notice  of Proposed  Rulemaking.  States participate  in the program 
when they submit  an At-Risk Child  Care  plan as an amendment  to the State Supportive 
Services  Plan,  and receive  approval  by the HHS Secretary. 
The At-Risk Child Care  final regulations,  published  on August 4,  1992, give States 
considerable  latitude  in implementation.  For example,  they are permitted  to define  low 
income  and  at risk.   Low income  may be set at a percentage  of the Federal  poverty 
level,  a percentage  of the States median  income,  or some other calculation.  At risk may 
be defined  in terms  of low income  alone,  or in combination  with other  risk factors 
which the State may establish. 
State Administration.  The State agency  responsible  for administering  or supervising  the 
States title IV-A Plan is also responsible  for the At-Risk  Child Care  program.  This 
agency must submit  its plan to the Secretary  for approval,  as an amendment  to the State 
Supportive  Services  plan. 
Funding.  Federal  funding for the At-Risk  Child Care  program,  in the form  of Federal 
Fimncial  Participation,  was $300 million  in each of Fiscal  Years  1991,  1992, and  1993. 
A States share of the national  total of available  funds for a fiscal year  is based on the 
ratio of the number  of its children  under  13 to the national  total of children  under  13. 
According  to ACF  this age limit is used because  it conforms  to age limits  for the AFDC, 
Transitional  and Child Care  Development  Block Grant programs.  Also,  each State defines 
its At-Risk population,  making  national,  low-income  population  measures  impractical. 
States must expend  their  funds in cash at their Fedem-l Medical  Assistance  Percentage 
2
 riiws, in order  to rccciw  IT-P.  These cxpcndimrcs  are  reported  to ACF on a quarterly 
basis. 
For  its firs[ year,  a Sti]te may request  Fedcrd  funds up to its limitation.  The  limitation 
represents  the States share by formula  of the amount  appropriated  for the fiscal year.  If 
a State does not claim  the full limitation,  then  the  difference  between  the  limitation  and 
[he total claims  paid for the fiscal year  is added to the next years  limitation.  The sum of 
the second  years  limitation  and the excess  funds from the first year comprises  the States 
maximum  grant.  A State may claim  its full maximum  gmnt  for the second year. 
States may add to each years  limitation  only the amount  that represents  the difference 
between  the prior  years  limitation  and the total  in claims  paid for the prior  year.  This 
ensures  that the statutory  requirement  is met,  i.e..  that excess  funds for one fiscal year  are 
only used for the immediately  succeeding  fiscal year. 
Familv  Contributions.  The State IV-A agency  must establish  a sliding  fee formula,  based 
on the familys  ability  to pay,  which provides  for contributions  from each family  towards 
the cost of care.  The agency  may waive contributions  if a familys  income  is at or below 
the poverty  level for a family of the same size.  States have the option of collecting  fees 
from families  or of having  the family pay fees directly  to providers. 
Arraruzements for Services.  A State may use any of several  methods  of payment  to 
provide  care,  while allowing  the family the opportunity  to choose  the arrangement.  if 
more than one category  of child care  is available.  Options  include child care  centers  and 
family child care providers. 
METHODOLOGY 
We selected  a purposive  sample  of  16 States:  12 drawn  from those 45 with approved  At-
Risk State plans and with At-Risk  Child Care expenditures  qualifying  for finding  in FYs 
1991 and  1992; two from three  with approved  State plans but with no expenditures 
qualifying  for funding;  and two of three  which did not submit  State plans for approval. 
This purposive  sample permitted  a selection  of small,  medium  and large  States with varied 
patterns  of participation  and expenditures.  The States with approved  plans and with FFP 
drawnare Arkansas,  California,  Connecticut,  Indiana,  Massachusetts,  Mimesota,  New 
York,  North  Carolina,  Oklahoma,  South Dakota,  Texas,  and Utah.  Louisiana  and West 
Virginia  were approved  for funding  in FY  1991 and FY  1992 but did not draw  down 
funds;  Louisiana  has not started  an At-Risk Child Care program,  while West Virginia 
implemented  its program  in the first month of FY  1993.  It has not yet been able to draw 
down any Federal  finds  for At-Risk  Child Care because  that program  is on a credit  line 
which  is experiencing  financial  difficulty.  Michigan  and Tennessee  did not apply for 
funding  in FYs  1991-1992.  We selected  the latter four  States in order  to learn  why they 
drew  down no FFP or chose  not to apply.  The sample  States expenditures  qualified  for a 
total of $172.4  million  in FFP  for both FYs,  representing  45 percent  of all qualifying 
expenses  for that period.  Twelve  of the  13 States with At-Risk  programs  have 
3
 implemented  them Statewide:  the other  Swtc has smcral coun[ics which chose  not to have 
.4t-Risk programs. 
.41116 sample  States were contacted  in March  1993 to Icarn the basis  for their decisions 
regarding  the program.  They provided  related  data and documents  at our request.  From 
the  13 States with At-Risk programs,  we sclcctcd  a total  of 92 rmpondcnts  purposively 
and interviewed  [hem by phone during  .April, May,  and June  1993.  They  included  16 
State officials.  16 local agency  representatives,  40 child care providers,  and 20 
representatives  of advocacy  groups. 
We analyzed.  both qualitatively  and quantitati\ely,  State and local documents  and records 
and key intemiew responses  by all respondent  groups. 
FINDINGS 
DESPITE  SLOW START,  N40ST  SAhfPLE  STATES  NOW  EXPECT  TO  MAKE 
FULL  USE  OF  AVAILABLE  AT-RISK  CHILD  CARE  FUNDS 
Only seven of the  13 sample  States with At-Risk programs  drew down Federal  At-Risk 
funds in FY  1991.  However.  this increased  to 12 States in FY  1992.  The total amount  of 
At-Risk expenditures  by the  13 States in FY  1991 was $46.1  million,  which qualified  for 
47 percent  of available  Federal  funds.  In FY  1992, expenditures  nearly  tripled,  resulting 
in the use of 76 percent  of available  funds for both years.  (See Table  1 below. )  Eleven 
of the  12 States with data report  serving  more children  in the At-Risk  Child Care program 
in FY  1992 than in FY  1991.  One State reports  serving  the same number. 
The experience  of the sample  States is similar to the national  experience.  For FY  1992, 
48 State At-Risk Child  Care programs  (including  the District  of Columbia)  were approved 
for finding.  According  to ACF,  through  May  1993, 45 States have reported  expenditures 
eligible  for $406.1  million  in FFP.  This represents  68 percent  of the $600 million 
available  for FYs  1991-92.  Most of these expenditures  ($309 million)  took place  in FY 
1992. 
For the first half of FY  1993, all sample States with At-Rkk  programs  report  expenditures 
totalling  $56.5  million.  All but one of these States expect  to qualify  for the full amount of 
Federal  funds in FY  1993. 
A number  of factors  appear  to have contributed  to the slow start.  As noted earlier,  At-
Risk Legislation  was signed in November  1990, but was effective  October  1, 1990.  The 
Family  Support Administration,  ACFS predecessor,  sent instructions  to States on how to 
apply for At-Risk  Child  Care  finding  in December  1990.  On June 25,  1991, ACF 
published  a Notice  of Proposed  Rulemaking.  Thus,  States could not implement  the At-
Risk Child  Care program  when it was first effective.  States also needed  time to 
appropriate  State matching  fimds,  further  delaying  implementation.  According  to most 
4  respondents,  their  expenditures  in FY  92 primarily  because 
states  initiated  or  incrcascd 
[heir legislatures  made  initial  or additional  matching  funds  available.  This  allowed  them 
K) establish  or expand  [heir programs.  In some States with county-administered  programs, 
some counties  experienced  further  delays because  States were S1OWto disburse  At-Risk 
Child Care  funds to them. 
The three  sample  Staws without  A[-Risk programs  cite a  of available  State funding  as 
]UCk 
the  primary  reason  for  not  implementing  a progmrn  in FY  1991  and  FY  1992.  However. 
one has had its program  approved  and is providing  services;  another  is awaiting  ACF 
approval  of its program.  The third continues  to lack matching  funds and does not expect 
to have an At-Risk program  in FY  1993. 
STATES  REPORT  TARGETING  FAhIILIES  N1OST  AT  RISK  OF  GOING  ON 
JYELFARE 
The  13 sample States with At-Risk programs  have set a wide range of income  eligibility 
scales for the At-Risk  Child  Care  program.  Their  ceilings  for a family of four range  from 
$17,982  to $40,491.  (See Table  1 below. )  However,  States believe  they are serving  the 
families  in greatest  need of child care.  In all  13 States,  respondents  estimate  that most of 
the families  actually  receiving  services  have annual  incomes between  $10,000  and 
$15,000.  One State respondent  says that families  at the high end of the income eligibility 
scale do not even apply  for At-Risk child care.  As a familys  income  increases,  it is 
required  to pay a greater  percentage  of its child care fees. 
States have set their  income  eligibility  ceilings  for different  reasons.  For example,  some 
with high eligibility  ceilings  chose a percent  of their  State median  income  which matched 
the liberal  rate previously  set for their  own State-subsidized  child care programs.  Most 
States also have the same  income eligibility  levels for their At-Risk and block  grant child 
care programs.  Another  State chose  its level to allow families  to remain  eligible  if their 
income  increased,  but they still needed  some subsidized  child care.  Others  established 
their levels because  of the high cost of living,  coupled  with high child care  costs,  in their 
States.  In two of the latter  States,  income eligibility  ceilings  are high,  but families  must 
have incomes of under  $27,000  to establish  initial eligibility.  (See Table  1 below.) 
States have made various  efforts  to serve the neediest  families,  as illustrated  by their 
experience  with waiting  lists for child care and outreach  activities: 
1.  Eight States have general  waiting  lists for all of their subsidized  child  care 
programs  with eligible  At-Risk  Child  Care families  currently  on them.  Seven of 
these give priority  to what they deem to be the most vulnerable  families.  In four 
of these States,  families  previously  on AFDC,  including  former  Transitional  Child 
Care  recipients  and caretakers  without a high school diploma  or GED,  are placed 
on the top of the list; those families  not previously  enrolled  in any subsidized  child 
care program  are given lower priority.  In the three  remaining  States with county-
5  TABLE  1 
SA31PLE  STATE  CHARACTERISTICS  RAXKED  BY  LNCONIE 
ELIGIBILITY  CEILINGS  FOR  A FAhfILY  OF  FOUR 
.,.-----,.--~---.- .- -- ------.-.-,....   .. -------.....---.  ..,.-e  ..-.. s-_..-.  -&.., -..-.  -
S 
, SOURCE  OF 
T  EXPEND- EXPEND- ~TCOhiE
FAIAP  BASE
A  ITURE  ITURE  ELIGIBILITY
%  LNCONIE
T  % 91  % 92  CEILINGS
AYD  70
E 
,-.---- --..  - .. .__  ...
xc  100  60  66  57%SM1  $17,982#
..  ._  .-   ...   
AR  o	 13  74  S1.i38/MO  $18,460# 
OK  0  70  $1.674/MO  $20,088#  ~ 
o 0  77  60%SMI 
SD  o  13  71  150%FPL  $21,600#  ~ 
25 
TX  67  64;  150%FPL  $21,600#  ~ 
UT  75  22  75  :  59%SMI  $22,793#  ~ 
IN  o  51  63  190%FPL  $27,360#  i 
:KY  100:  100  I  50  ~  200%FPL  ~  $28,800#  ~ 
50  / 
CA  o  200  I  84%SMI  \  $37,955#  : 
CT  75  125 i  50  ~  50%SMI  :  $26,965+  +  ! 
I 
$40,448  ~ 
~ MA  ;  100,  100  50  i  50%SMI  !  $26,994+  +  ~ 
I 
I  $40,491  ~ 
Eligibilityin theseStatesbegins  at or below  these  income  levels  and ends  when  these  levels  are

exceeded.

++  The  income  for a family  of four must be below  these levels  to establish  eligibility;  thereafter,  income

may  increase  to the second  figure  before  eligibility  may be terminated.

* 
Includes  prior  year  FFP  not previously  matched.

FMAP: Federal  Medical  Assistance  Percentage  (matching)  rate:  averaged  for the two years  and rounded

SM1:  1992/1993  State Median  Income  - family  of four

FPL:  1992 Federal  Poverty  Level  - family  of four:  $14,400

6  administered  programs.  priority  uas gilwn to the neediest  fdmilies  in some counties 
where  former  Transitional  Child Cart  recipients  and low-income  fami!ics are 
targeted.  A Stute  respondent  underscores  this priority  process,  stating:  WC 
always try to reach  (he low-income  families just  off or rcccntly  off AFDC.  They 
get first priority  for this program.   Another  State respondent  offers:  Its my 
sense that most At-Risk families  are former  TCC  recipients.  
-)  Respondents  from  12 of the  13 States mention  (hat they ad~ertise their  subsidized 
-.

child care  programs,  including  the At-Risk  program,  primarily  to the neediest 
f~mi]ies.  For example.  they focus their publicity  efforts  on low-income 
communities,  welfare  offices and Food Stamp offices. 
STATES  ARE  COORDINATING  THE  AT-RISK  CHILD  CARE  PROGRAhi  WITH 
OTHER  SUBSIDIZED  CHILD  CARE  PROGRAhlS;  SOhlE  CONCERNS 
EXPRESSED 
States report thal they are providing  seamless  citi[d care services 
All of the State respondents  from the  13 States with At-Risk Child Care  programs  believe 
that their  States are coordinating  the different  child care  funding  streams.  Five States 
have established  either  a single government  unit for the different  child care  programs  or 
combined  the administration  of them.  Four  States have promoted  good relations  between 
different  State agencies  and with child care providers  and advocates.  For example,  they 
have established  State child care task forces or cabinets.  One State respondent  says,  We 
brought  partners  together  that never  really talked before.  
States administrative  processes  have also enhanced  coordination.  The designated  State 
IV-A agency directly  administers  the At-Risk Child Care  program  in six of the  13 States; 
in the remaining  seven,  the agency contracts  with outside  agencies,  including  other  State 
offices  and resource  and referral  agencies,  to administer  part or all of the program.  In 
one State,  child care  provider  organizations  operate  the program  on a day-to-day  basis 
under  contractual  arrangements  with the State.  In another,  each county  has a local 
council,  comprised  of schools,  local government,  nonprofit  agencies,  providers  and 
consumers,  which conducts  needs assessments  and develops  a plan of action.  These 
councils,  directly  or by contract,  also coordinate  the different  child care  funding  streams, 
determine  eligibility  and process  applications. 
Most States utilize  the same policies  on income eligibility,  payment  rates  and sliding fee 
scales for At-Risk  Child  Care,  and Child Care  Development  and Social Services  Block 
Grants.  (See Table  2 below).  Families,  therefore,  are able to retain  or change  providers 
without being burdened  with how,  and by whom,  their child care  is subsidized.  One State 
respondent  says,  Weve attempted  to make funding streams  invisible  to families  and 
providers.  
7  TABLE  2 
STATES  POLICIES  OX  CCDBG  AXD  SSBG  lNCO\lE  ELIGIBILITY,  PAY\lEXT  RATES, 
AND  FEE  SCALES  CO\lPARED  IVITH  THOSE  FOR  AT-RISK  CHILD  CARE 
POLICIES  STATE  RESPONSES 
.  .  .  .  ..  ...  ....  .  ..  .,--- .-. .  ..... .... 
xc  N OK 
SA31E AS AT-RISK?  AR  CA  CT  IN  31A  31N  SD  ~ T?i  UT  \?V 
-.  .  .- ..  .. .... .....  .....   .. .....   .... ..._._.,.   ......  ..  ..-  _,... ...  .. .
CCDBG  I?JCOhfE  YNYYYYY  Y  YYYYY 
ELIGIBILITY 
.   ..  ,.  .. ......  -.....,..-   .-.. -<.  ..  .... .
CCDBG PAYMENT  Y  N  Y Y Y  Y  Y N Y  YYY  Y 
RATES 
.... ._..    .  :.  . 
CCDBG  FEE  YYYYYYY  YYY  :Y:  Y:Y: 
1 
SCALES 
.-.. ... .   ...,_____  ...  .. .  . _____ ...__  ,,  _._.  ._ ___..__ ,  ~  ~
SSBG INCOME  Y  NA*YY:NAYY:  NY  NAi  YjYY 
ELIGIBILITY  I
  ..,  .  .~      I      -..__.4.___U
! 
SSBGPAYMENTYi  NAYj  N:  NAYi  NY,  Y;NA  jY~Y  ~Y 
[ 
IUTES  :  !  1 
I  1 
.- _  .  . .  .;    ~  u    . 
SSBG FEE  tY~NA\Y\YINA~Y~  Y~YY~NAIYJYY  ~ 
l~,i]~~l 
SCALES  ! ~    ~  ~  I
.-._  .  _J_._ - - .. J ~.~  ~  - .  .;  -  J=J~ 
*  The designation  NA represents  Not applicable,  as the State does not use SSBG funds for child care. 
Several  States also sequence  the different  child care  funding  streams.  Four  States use all 
of their block  grant money  before  drawing  down funds for matching  programs.  Eight 
require  that families use Transitional  Child Care before  receiving  At-Risk  services. 
Several  of these eight States automatically  inform Transitional  Child  Care  recipients  that 
they are eligible  for At-Risk  services  once their Transitional  benefits  have expired. 
Concerns  exist about the variation  among different  child care funding  streams 
While  States believe  they are effectively  coordinating  the At-Risk  Child  Care program 
within their  States to provide  seamless  services,  it is not without difficulty.  Many  State, 
local and advocate  respondents  feel that States are accomplishing  this despite  funding  and 
statutory  variations  among  Federal  funding  streams  which make them fragmented, 
inconsistent  and difflcuh  to administer. 
COMMENTS 
We shared  a copy of the draft  of this report  with ACF  and subsequently  met with ACF 
representatives  to discuss  their comments.  All of ACFS comments  were technical  in 
nature,  and corresponding  changes  have been  incorporated  into this final report.