Maryland Early Childhood Profile

Overview

The Early Childhood Two-Generation State Policy Profile shows which state policies meet benchmarks that are favorable to the well-being of children and their families. The profile includes policies that are key elements of a two-generation approach to supporting the well-being and life opportunities of young children and their parents, in the areas of health, early care and education, and parenting and economic support.

A two-generation framework for policy design reflects extensive research that identifies the critical supports young children need over time to thrive1, 2. Most two-generation supports for young children and families are created through the collective impact of multiple policies. An example is investment in prekindergarten programs and an effective quality improvement system that promotes children’s access to high quality early care and education programs along with state policies such as the Earned Income Tax credit and minimum wage that raise the incomes of low-income working families; another is policies that ensure mental health screenings and access to quality health care for both children and parents.

A brief overview of policies in the EC Two-Generation State Policy Profile is provided below (see policy definitions for an explanation of benchmarks). The Profile is limited to policies for which 50-state data are available. Users who wish to examine additional policies specific to their state, within a two-generation framework, can find suggestions in State Policies through a Two-Generation Lens: Strengthening the Collective Impact of Policies that Affect the Life Course of Young Children and their Parents.

Health and Development

States can support young children's development by making key policy choices in early health and development. This section of ITO highlights states' policy choices for supporting young children's wellbeing: 1) Access to and continuity of health care, including state Medicaid/CHIP eligibility levels and coverage of legal immigrant children; 2) Parents' access to health care, including for low-income pregnant women, and access to a medical home for young children; and 3) Preventive screening and assessment, including adherence to recommended schedules for well-child visits.

Early Care and Education

States make important decisions about the early care and education services they provide to young children and families. This section of ITO highlights states' key policy choices that affect children's development and parents' ability to work: 1) Access to childcare, including subsidy eligibility levels and reimbursement rates; and 2) States' investment in Head Start, Early Head Start, pre-kindergarten, child care centers' class size and student-teacher ratios and investment in infant/toddler specialist networks and credentials and Quality Rating Improvement Systems.

Parenting and Economic Supports

States make critical policy choices that help low-income parents effectively support young children's healthy development. This section of ITO spotlights states' policy choices related to important economic supports for low-income families with young children: 1) TANF requirements for parents of young children; and 2) Income support policies including tax relief, earned income and dependent care tax credits, as well as child support disregards.

Young children (under age 6)3: 431,019

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* This graph includes all possible risk factors: poor, single parent, teen mother, low parental education, nonemployed parents, residential mobility, households without English speakers, and large family size.

Health and Development Policies

Sets the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) [2021]4

  • Children <1 year
    Eligibility is up to 194% for Medicaid and 322% for M-CHIP.
  • Children 1-5 years
    Eligibility is up to 138% for Medicaid and 322% for M-CHIP.
  • Children 6-18 years
    Eligibility is up to 133% for Medicaid and 322% for M-CHIP.
  • Pregnant women
    Eligibility is up to 264% for Medicaid and for the From-Conception-to-End-of-Pregnancy (FCEP) CHIP-funded option.
  • Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2024]7
  • Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2024]7
  • Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2021]8
  • Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2022]9
  • Extends Medicaid coverage for family planning to otherwise ineligible low-income women [2023]10
    Eligibility based on income up to 259% FPL, including men and individuals younger than 19 years of age. State also extends Medicaid eligibility for family planning services to people losing full-benefit coverage after the end of the postpartum period.
  • Includes at-risk children in the definition of eligibility for IDEA Part C [2023]11
    The relationship between being an at-risk state and the number of children served varies. Some non-at-risk states have higher than average percentages of children being served in Early Intervention (EI). EI participation data in MD were not reported for 2021-2022.
  • Does not require redetermination of eligibility for Medicaid/CHIP more than once a year [2022]12
  • Has adopted Medicaid expansion as part of the Affordable Care Act [2023]13
  • Has an online dual-benefit form to apply for Medicaid and SNAP [2024]14
  • Medicaid pays for maternal depression screening during pediatric/family medicine visits under the child's Medicaid [2021]15
  • Has at least one Help Me Grow affiliate site that has fully implemented a centralized access point [2023]16
    Maryland does not have Help Me Grow.

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2020]17

  • 7 screenings for children <1 year
    State requires 6 screens. 100% of eligible screens were completed in 2021.
  • 4 screenings for children 1-2 years
    State requires 5 screens. 87% of eligible screens were completed in 2021.
  • 3 screenings for children 3-5 years
    State requires 3 screens. 83% of eligible screens were completed in 2021.
  • 4 screenings for children 6-9 years
    State requires 4 screens. 64% of eligible screens were completed in 2021.

50-State Data    Information on EC Policies

Source 3

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* EI rates are not displayed where the cell size is small as the data are not reliable.

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Early Care and Education Policies

  • Sets the income eligibility limit for child care subsidies at or above 200% FPL [2022]20
    A family of three qualifies for assistance with a maximum income at $60,081 or 261% FPL. This reflects a decrease from 274% FPL in 2020.
  • Uses payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier [2023]21
    The reimbursement rate for center care for a four-year-old in Region W at the highest quality tier was 26% higher than the rate at the lowest quality tier.
  • Funds a pre-kindergarten program [2023]22
    $224,382,022 from 2022-2023.
  • Supplements Head Start [2023]22
    $2,440,960 from 2022-2023.
  • Requires districts to offer full day kindergarten [2023]23
  • Requires one adult for every four 18-month-olds in child care centers [2023]24
    Child care regulations require one adult for every 3 children.
  • Requires one adult for every ten 4-year-olds in child care centers [2023]24
  • Requires one teacher for every 12 students in kindergarten classrooms [2023]23
    Not specified in statute or regulation
  • Has an infant/toddler credential or certificate [2021]25
  • Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver [2023]24
  • Has implemented a statewide Quality Rating Improvement System (QRIS) [2024]26
  • Has comprehensive, free-standing standards for social emotional learning at the K-12 level [2023]27
    Has comprehensive, free-standing standards for SEL, Pre-K to grade two.
  • Requires a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers [2020]28
    Only lead teachers in public pre-K programs are required to have a minimum of a bachelor's degree.

50-State Data    Information on EC Policies

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Parenting and Economic Supports Policies

  • Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2022]31
    Recipients caring for a child under 12 months old are exempt, yet exemption is limited to 12 cumulative months in the recipient's lifetime. A recipient caring for a child under age 6 who is unable to obtain child care may be exempt from work activities or sanctions.
  • Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2022]32
    The state requires recipients to work 40 hours per week, but recipients caring for a child age 6 or older are not sanctioned if working at least 30 hours per week. Recipients caring for a child under age 6 are not sanctioned if working at least 20 hours per week.
  • Has paid family leave for a minimum of 6 weeks with partial replacement of wages [2024]33
    Enacted 2022, effective July 2025 (premiums) and July 2026 (benefits).
  • Offers accrual of at least five paid sick days [2023]34
    Employees can earn up to 40 hours per year as well as accrue and use up to 64 hours of unpaid time off in businesses with 1-14 employees. Employees can earn 40 hours per year as well as accrue and use up to 64 hours of paid time off in businesses with 15+ employees.
  • Established a state minimum wage that meets or exceeds $12.00/hr and is indexed to inflation for a family of three [2022]35
    $12.50
  • Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP [2022]36
  • Does not charge personal income tax for single-parent families of three below the federal poverty level [TY 2022]37
  • Offers a refundable state Earned Income Tax Credit [2024]38
    28% of the federal EITC. Maryland also offers a non-refundable EITC set at 50% of the federal credit. Taxpayers may claim either the refundable credit or the non-refundable credit, but not both. Localities also offer an EITC.
  • Offers a refundable state dependent care tax credit [TY 2023]39
    Under Maryland Credit for Child and Dependent Care Expenses, the maximum credit is $672. The credit is refundable for families with an adjusted gross income of $52,100 or less for individuals or $78,150 or less for married couples filing jointly. Under Maryland Child and Dependent Care Expenses Subtraction, the maximum nonrefundable credit is $345. Eligible tax filers may claim both of this state's child and dependent care tax provisions.
  • Offers a refundable Child Tax Credit [2024]40
    Maryland's refundable CTC offers $500 per child under age 6 or under age 17 and with a disability. Taxpayer's federal adjusted gross income must be at least $6,000 or less.
  • Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2023]21
  • Offers exemptions and/or extensions of the TANF benefit time limit for women who are pregnant or caring for a child under 6 months of age [FY 2021]41
  • Offers a minimum of 28 weeks of Unemployment Insurance benefits [2024]42
    State provides up to 26 weeks of regular state-funded UI.
  • Funds a housing program that provides rental assistance to low-income families with children at 80% AMI/200% FPL or less to avoid eviction or homelessness [2024]43

50-State Data    Information on EC Policies

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Source 44

Data Notes and Sources

  1. Chase-Lansdale, P. L., & Brooks-Gunn, J. (2014). Two-generation programs in the twenty-first century. The Future of Children, 24(1), 13-39.
  2. Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and psychopathology, 25(4pt2), 1635-1653.
  3. State data were calculated from the 2016-2020 American Community Survey, representing information from the years 2016 to 2020. National data were calculated from the 2019 American Community Survey, representing information from 2019. We did not use the 2020 American Community Survey data for the U.S. due to the dataset's experimental nature and caution about its reliability.
  4. Brooks, T., Gardner, A., Tolbert, J., Dolan, R., & Pham, O. (2021). Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2021: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. https://files.kff.org (accessed June 25, 2021).
  5. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 1, 2024, from https://www.kff.org
  6. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 9, 2024, from https://www.kff.org
  7. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved September 19, 2024, from https://www.kff.org
  8. Centers for Medicare and Medicaid Services. (2021). Presumptive eligibility. U.S. Department of Health and Human Services. Retrieved July 14, 2022, from https://www.medicaid.gov
  9. Brooks, T., Gardner, A., Osorio, A., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2022). Medicaid and CHIP eligibility and enrollment policies as of January 2022: Findings from a 50-state survey. Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved February 8, 2023, from https://files.kff.org
  10. Guttmacher Institute. (2023). Medicaid family planning eligibility expansions. Retrieved September 26, 2023, from https://www.guttmacher.org
  11. The Early Childhood Technical Assistance Center. (n.d.). State and jurisdictional eligibility definitions for infants and toddlers with disabilities under IDEA Part C. FPG Child Development Institute, University of North Carolina at Chapel Hill. Retrieved February 15, 2023, from https://ectacenter.org
  12. Brooks, T., Gardner, A., Osorio, A., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2022). Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2022: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. https://files.kff.org (accessed July 7, 2022).
  13. The Kaiser Family Foundation. (2023). State health facts: Status of state action on the Medicaid expansion decision. Retrieved October 1, 2024, from https://www.kff.org
  14. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 1, 2024, from https://www.kff.org
  15. National Academy for State Health Policy. (2021). Medicaid Policies for Maternal Depression Screening During Well-Child Visits, by State. https://healthychild.nashp.org (accessed February 26, 2021).
  16. Help Me Grow National Center. (n.d.). Help me grow network affiliates. Retrieved June 21, 2024, from https://helpmegrownational.org Email correspondence from Melissa Miller on June 10, 2024.
  17. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2022). The Annual EPSDT Report (Form CMS-416) for FY 2020. https://www.medicaid.gov (accessed July 8, 2022).
  18. Early Intervention (EI) rates were calculated by using data from two sources: 2018-2019 EI cumulative counts collected by the US Department of Education and 2011-2019 American Community Survey data. Estimates of the population of children under 3 were averages of single-year ACS data from 2011 to 2019. EI rates are not displayed where cell size for the numerator (number of children in EI) is missing, or cell size for the denominator (total number of children) is less than 200.
  19. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2019). The Annual EPSDT Report (Form CMS-416) for FY 2019. https://www.medicaid.gov (accessed January 25, 2021).
  20. Schulman, K. (2023). Precarious progress: State child care assistance policies 2022. National Women's Law Center. Retrieved June 13, 2023, from https://nwlc.org
  21. Schulman, K. (2024). Two steps forward, one step back: State child care assistance policies 2023. National Women's Law Center. Retrieved June 12, 2024, from https://nwlc.org
  22. Friedman-Krauss, A. H., Barnett, W. S., Hodges, K. S., Garver, K. A., Jost, T. M., Weisenfeld, G. G., & Duer, J. K. (2024). The state of preschool 2023: State preschool yearbook. National Institute for Early Education Research. Retrieved June 22, 2024, from https://nieer.org
  23. Education Commission of the States. (n.d.). State education policy tracking. Retrieved August 24, 2023, from https://www.ecs.org NCCP also referenced: Fischer, A., Jamieson, C., Silva-Padron, G., Peisach, L., & Weyer, M. (2023). ECS's 2023 50-state comparison: State kindergarten-through-third-grade policies. Education Commission of the States. Retrieved August 24, 2023, from https://www.ecs.org
  24. Child Care Technical Assistance Network. (n.d.). National database of child care licensing regulations. Office of Child Care, Administration for Children & Families, U.S. Department of Health & Human Services. Retrieved August 23, 2023, from https://licensingregulations.acf.hhs.gov
  25. Zero to Three. (2021). The State of Child Care for Babies: The Need to Do Better for Our Youngest Children. https://stateofbabies.org (accessed December 1, 2022).
  26. The Quality Compendium. (2024). State profiles. The BUILD Initiative. Retrieved March 13, 2024, from https://qualitycompendium.org
  27. Collaborative for Academic, Social, and Emotional Learning (CASEL). (n.d.). Social-emotional learning policy at the state level. Retrieved July 31, 2023, from https://casel.org
  28. McLean, C., Austin, L. J. E., Whitebook, M., & Olson, K.L. (2021). Early childhood workforce index: 2020. Berkeley, CA: Center for the Study of Child Care Employment, University of California, Berkeley. Retrieved March 10, 2021, from https://cscce.berkeley.edu
  29. Schulman, K. (2020). On the Precipice: State Child Care Assistance Policies 2020. National Women's Law Center. https://nwlc.org (accessed July 15, 2021).
  30. U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. (2019).?National Assessment of Educational Progress (NAEP), 2019 Math and Reading Assessment. https://nces.ed.gov June 30, 2020).
  31. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov
  32. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov NCCP reviewed state policies for OR and WI as of March 27, 2024.
  33. National Partnership for Women & Families. (2024). State paid family and medical leave insurance laws. Retrieved October 1, 2024, from https://www.nationalpartnership.org
  34. National Partnership for Women & Families. (2023). Paid sick days - State and district statutes. Retrieved April 5, 2024, from https://nationalpartnership.org
  35. National Conference of State Legislatures. (2022). State Minimum Wages. http://www.ncsl.org (accessed May 4, 2022).
  36. Aussenberg, R.A., & Falk, G. (2023). The Supplemental Nutrition Assistance Program (SNAP): A primer on eligibility and benefits (CRS Publication No. R42505). Congressional Research Service. Retrieved August 28, 2023, from https://crsreports.congress.gov
  37. NCCP's calculations derived from output generated by the National Bureau of Economic Research Internet TAXSIM Version 35, available at https://taxsim.nber.org for the 2022 tax year. For a description of the TAXSIM model, see Feenberg, D. and Coutts, E. (1993). An Introduction to the TAXSIM Model. Journal of Policy Analysis and Management 12(1): 189-194.
  38. Tax Policy Center. (2024). State EITC as Percentage of Federal EITC. Urban Institute & Brookings Institution. Retrieved October 1, 2024, from https://www.taxpolicycenter.org For CA, CO, CT, HI, ME, MO, MT, NM, UT, VA, & WA, NCCP also referenced: Tax Credits for Workers and Families (2024). State Tax Credits. Retrieved October 1, 2024, from https://www.taxcreditsforworkersandfamilies.org
  39. National Women's Law Center. (2024). States can make care less taxing, tax credits related to child care, tax year 2023. Retrieved April 5, 2024, from https://nwlc.org
  40. National Conference of State Legislatures. (2024). Child tax credit overview. Retrieved October 1, 2024, from https://www.ncsl.org
  41. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare Rules Databook: State TANF Policies as of July 2021. OPRE Report 2023-001. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov (accessed August 22, 2023).
  42. Center on Budget and Policy Priorities. (2024). Policy basics: How many weeks of unemployment compensation are available? Retrieved September 16, 2024, from https://www.cbpp.org
  43. National Low Income Housing Coalition. (n.d.). Rental housing programs database. Retrieved April 16, 2024, from https://nlihc.org
  44. Shantz, K., Dehry, I., Knowles, S., Minton, S., & Giannarelli, L. (2020). Welfare Rules Databook: State TANF Policies as of July 2019. OPRE Report 2020-141. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://wrd.urban.org (accessed February 2, 2021).