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Even before the COVID-19 pandemic, many families lacked access to affordable childcare. The height of the pandemic highlighted the need for childcare services more than ever. The economic strain it caused threatened to collapse the entire childcare system. These effects especially impacted nurses and other essential personnel.
The Center for American Progress identifies 4.6 million, or 30%, of healthcare workers as parents or guardians of children under 14. With many nurses working nontraditional shifts, there is a desperate need for access to affordable, reliable childcare.
As our nation encounters rising healthcare demands and staff shortages of essential employees, millions of healthcare workers need childcare support to continue working. This gave birth to the critical need for emergency childcare and has left the industry scrambling for resources.
With childcare serving as a lifeline, many find themselves faced with the difficult decision to leave nursing for another career or to stay home with their children.
Keep reading to learn more about the specific challenges of improving affordable childcare access and available resources for nurses.
The Current State of Childcare for Nurses
The U.S. Department of Health and Human Services identifies affordable childcare as a program that costs no more than 7% of a family's income. None of the 50 states meet these criteria. In fact, care for only one infant in the District of Columbia would eat up almost 29% of a median family's income.
The costs for childcare vary from state to state but could be considered a major expense in most regions. According to the Economic Policy Institute (EPI), the highest annual childcare cost for 2022 is Massachusetts at $20,910 and the lowest is Mississippi at $5,440.
In 35 states, the cost of childcare surpasses college tuition. In the District of Columbia, it costs four times more annually to have your infant in care than to have your child enrolled in college full time.
According to the Economic Policy Institute, the highest annual childcare cost for 2022 is Massachusetts at $20,910 and the lowest is Mississippi at $5,440.
In 2020 at the height of the pandemic, a whole new list of issues presented themselves adding additional strain to an already fragile system. Schools closed and virtual schooling became the norm, leaving school-age kids homebound. Some childcare facilities or providers were forced to close their doors. Others were ordered to decrease their enrollment to follow national and state guidelines.
The limited accommodations posed an issue with families nationwide, particularly among minority communities. In a Columbia University study, 42% of Asian families, 40% of Latino families, and 38% of Black families dealt with childcare facility closings from March 2020 onward compared to only 28% of white families who were affected.
Certain sectors of the workforce were also disproportionately affected. The healthcare industry never shut down through the pandemic. Many healthcare providers were left with little time or resources when faced with the wave of COVID-19 patients while also caring for their families at home.
As the largest occupation in the healthcare sector, nurses faced specific childcare challenges including finding flexible childcare options that were compatible with longer and later shifts.
Ways to Improve Access to Childcare for Nurses
Quality childcare is a top priority in both single-parent households and dual-income families. Whether the convenience of an onsite program or considering other options, the current childcare system is in need of a complete transformation.
The following are ways to improve childcare access for nurses.
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1
Increase Onsite Employer-Based Childcare for Healthcare Workers
Onsite childcare is located at an employers' workplace. On the other hand, a consortium-sponsored center is financed by two partner employers. It is typically located near the healthcare facilities and run by a contractor. Some employers subsidize the expenses; others require the employee to cover the cost.
There are many benefits to onsite employer-based childcare including convenience and having the opportunity to be close to your children. For example, St. Joseph's Hospital offers onsite childcare at TodayCare Children's Center for their employees.
By offering this form of childcare, healthcare organizations may benefit from
- Decreased nurse turnover
- Increased retention
- Improved productivity at work
- Higher nurse satisfaction
In a 1993 study, nurses were least likely to explore other job opportunities in a company that offered employer-subsidized childcare. Additionally, this is a great perk to share with prospective nursing employees.
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2
Promote More Nurse-Friendly Childcare Providers
States across the nation place an emphasis on childcare options for first responders. Such programs Include emergency childcare, temporary pandemic childcare centers, and regional enrichment centers.
Nurse-friendly providers may provide nurses with a 24-hour daycare or childcare option with extended, or nontraditional, working hours. Overnight care facilities are equipped with beds and other resources to accommodate the children for bedtime.
Although it may be more expensive, a licensed provider could care for your child in home. This option allows the child to sleep in the comfort of their own bed while their parent(s) or guardians are working a nontraditional shift.
A non-licensed individual can provide in-home care as needed through family, friend, and neighbor care.
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3
Support Uniform Paid Family Leave
Pregnant nurses who are not privy to paid maternity leave benefits may be forced to return to work immediately after childbirth. Other nurses who are not offered paid family leave may have to take unpaid time off (which could lead to termination) or must quit their job.
The Family and Medical Leave Act offers eligibility to more than half of the workforce; this includes companies with 50 or more employees. Yet, restrictions are placed on coverage for the remaining 44% of personnel in smaller companies.
The National Compensation Survey determined that 87% of workers have some aspect of unpaid family leave available, while a mere 13% have access to paid family leave.
Directly related to the pandemic, a temporary paid family leave and medical leave program was designed to allow workers to take time off to care for themselves, or family members, without putting their job in jeopardy. The benefits offer parents or guardians of newborns or recently adopted children paid time off as well.
Enacting a permanent federal paid family leave program may result in improved mental and physical health, financial security, nurse retention, and increased job satisfaction.
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4
Other Employer Benefits
The U.S. Bureau of Labor Statistics Employee Benefits Survey reveals 30% of registered nurses have access to childcare benefits compared to only 11% of all workers.
Some states, such as Florida, offer an employer referral program where employers can refer employees. This program provides childcare at little or no cost. The Florida Department of Education's Office of Learning and local early learning coalitions throughout the state concentrate on childcare for healthcare workers and first responders for children from 0-13.
Flexible benefits plans or reimbursement programs can be individually designed for the employee.
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5
Federal Funding and Expansion in Childcare Deserts
A childcare desert is a census tract where the number of children outweighs the number of licensed childcare slots in a minimum ratio of 3:1. In 2018, the Center for American Progress discovered that 51% of Americans live in a neighborhood classified as a childcare desert.
Developing more high-quality, licensed programs in childcare desert areas is a national investment. Funding is essential. Building more facilities in these markets will target the population with the greatest demand and help to alleviate the supply-demand imbalance.
The largest source of federal funding is the childcare and development block grant (CCDBG). Low-wage nurses tend to have a more challenging time locating, and paying for, quality care.
The CCDBG Act provides childcare state assistance for children under 13 years old who are from low-income families.
Childcare Assistance Resources for Nurses
There is help. There are many resources for nurses at the federal and state level working toward childcare reform. Listed below are some sites offering childcare resources and tools to families.
State-Based Childcare Services
Listed in the table below are childcare services. Included are state-based services for essential or low-income families.
State | Service | Organization |
---|---|---|
Alaska | Parents Achieving Self Sufficiency | Alaska Department of Health and Social Services |
Arizona | Childcare Assistance | Arizona Department of Economic Security |
Arkansas | Essential Worker Childcare Assistance | Arkansas Department of Human Services |
California | COVID-19 Emergency Childcare | Community Action Partnership of Kern |
Colorado | Colorado Childcare | Colorado Office of Early Childhood |
Georgia | Childcare Subsidies for Essential Workers | Georgia Department of Early Care and Learning |
Hawaii | Childcare Connection Hawaii Subsidy | Hawaii Department of Human Services |
Idaho | The Idaho Childcare Program | Idaho Department of Health and Welfare |
Indiana | Build Learn Grow | Brighter Futures Indiana |
Iowa | Childcare Assistance | Iowa Department of Human Services |
Kansas | Hero Relief Program | Kansas Department for Children and Families |
Louisiana | Childcare Assistance Program | Louisiana Department of Education |
Maine | Childcare Subsidy Program | State of Maine Department of Health and Human Services |
Minnesota | Minnesota's Childcare Assistance Programs | Minnesota Department of Human Services |
Missouri | Childcare Subsidy Program | Missouri Department of Social Services |
Nevada | Childcare and Development Fund Childcare Program | The Children's Cabinet |
New Jersey | COVID-19 Family Differential Payments | State of New Jersey Department of Human Services Division of Family Development |
New Mexico | The Childcare Assistance Program | New Mexico Early Childhood Education & Care Department |
New York | Childcare Subsidy Program | NYS Office of Children and Family Services |
North Dakota | Childcare Assistance Program | North Dakota Department of Human Services |
Ohio | Publicly Funded Childcare Program | Ohio Department of Job and Family Services |
Oregon | The Employment Related Day Care Program | Oregon Department of Human Services |
Oregon — Polk or Marion County | Oregon Nurse Coronavirus Response and Relief Fund | Oregon Nurses Foundatio |
Pennsylvania | Childcare Works Subsidized Childcare Program | Pennsylvania Department of Human Services |
South Dakota | Childcare Assistance Program | South Dakota Department of Social Services |
Texas | COVID-19 Resources Childcare | Texas Workforce Commission |
Texas | Childcare Assistance | Texas Child Care Solutions |
Utah | Employee Support Childcare | Utah Department of Workforce Services |
Washington | Washington Connections Childcare | Washington State Department of Children, Youth, & Families |
Wyoming | Childcare Subsidy Program | Wyoming Department of Family Services |
Sources
- Blake, J. (1993). A study of childcare issues affecting the nursing profession in a major southwestern city.
https://corescholar.libraries.wright.edu/cgi/viewcontent.cgi?article=1043&context=econ_student - Child care costs in the United States. (2020). https://www.epi.org/child-care-costs-in-the-united-states/#/MS
- Employers: helping first responders and healthcare workers access child care. (n.d.).
https://www.jwbpinellas.org/wp-content/uploads/2020/04/Child-Care-Financial-Assistance-for-First-Responders-Healthcare-Workers.pdf - Gould, E, et al. (2017). What does good child care reform look like?
https://www.epi.org/publication/what-does-good-child-care-reform-look-like/ - Jorgensen, H, et al. (2014). Expanding federal family and medical leave coverage: who benefits from changes in eligibility requirements?
https://ideas.repec.org/p/epo/papers/2014-02.html - Lee, E, et al. (2021). The care burden during COVID-19: a national database of child care closures in the United States.
https://journals.sagepub.com/doi/pdf/10.1177/23780231211032028 - Malik, R, et al. (2018). America's child care deserts in 2018.
https://www.americanprogress.org/article/americas-child-care-deserts-2018/ - Novoa, C, et al. (2020).The U.S. coronavirus response must meet health workers' child care needs.
https://www.americanprogress.org/article/u-s-coronavirus-response-must-meet-health-workers-child-care-needs/ - Romig, K, et al. (2021). A national paid leave program would help workers, families.
https://www.cbpp.org/research/economy/a-national-paid-leave-program-would-help-workers-families - The fundamentals of CCDF administration resource guide. (2020).
https://childcareta.acf.hhs.gov/sites/default/files/public/resourceguide_ccdf_fundamentals_3.0_0.pdf - U.S. Bureau of Labor Statistics. (2021). National compensation survey: employee benefits in the United States, March 2021.
https://www.bls.gov/ncs/ebs/benefits/2021/employee-benefits-in-the-united-states-march-2021.pdf
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