This report was performed by Consad Research Corporation, and was sponsored by the Health Care Financing Administration. The report, The At-Risk Child Care Program , examines states' implementation of the program, and their successes and problems with it. The report finds that, in the thirteen sample states, there was a marked increase in the use of federal funds, as well as in state expenditures between fiscal year 1991 and 1992. States also report serving more children in FY 1992 than in FY 1991. States have considerable freedom to serve those families they consider most at risk.
States can also allow families substantial leeway in their choice of child care provider.
States generally use the same income eligibility and payment rates for this and other subsidized child care programs. As a result, states feel that they are providing seamless child care services, so that families may control delivery of their child care, regardless of how, and by whom, it is subsidized. However, differences in regulations and funding among the several funding streams make them difficult to coordinate and to administer. On the whole, then, states have been successful in their implementation of the program, increasing participation and funding, and delivering streamlined, seamless child care services to families at risk. This report was performed by the Office of Inspector General of the Department of Health and Human Services.