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Overview

Young children (under age 6)3: 1,274,928

Young children by income, 2015

Source3

Young children by race/ethnicity, 2015

Source3

Exposure to multiple risk factors among
young children, 2015*

Source3

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

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 higlights 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.


Health

State Choices to Promote Access

Young children under age 6 who
lack health insurance, 2015

Source3

Percent of eligible children who received at
least one EPSDT* screening, by age, FY 2015

Source4

Income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) [2017]5

  • Children <1 year
    Set eligibility at 215% (S-CHIP) and 211% (Medicaid and M-CHIP)
  • Children 1-5 years
    Set eligibility at 215% (S-CHIP)
  • Children 6-18 years
    Set eligibility at 215% (S-CHIP)
  • Pregnant women
    Set eligibility at 196% (Medicaid)
  • Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2017]6
  • Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2017]6
  • Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2017]6
  • Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2017]6
  • Includes at-risk children in the definition of eligibility for IDEA Part C [2014]7
  • Does not require redetermination of eligibility for Medicaid/CHIP more than once a year [2017]6
  • Has adopted Medicaid expansion as part of the Affordable Care Act [2017]8
  • Has an online dual-benefit form to apply for Medicaid and SNAP [2017]6
  • Medicaid pays for maternal depression screening during pediatric/family medicine visits under the child's Medicaid [2017]9

State Choices to Promote Quality

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2015]4

  • 7 Screenings for children <1 year
    State requires 7 screens. 94% of eligible screens were completed in 2015.
  • 4 Screenings for children 1-2 years
    State requires 5 screens. 89% of eligible screens were completed in 2015.
  • 3 Screenings for children 3-5 years
    State requires 3 screens. 82% of eligible screens were completed in 2015.
  • 4 Screenings for children 6-9 years
    State requires 4 screens. 53% of eligible screens were completed in 2015.
  • Requires newborn screening for the 31 metabolic deficiencies/disorders and core conditions [2014]10

Early Care and Education

State Choices to Promote Access

Monthly child care co-payment fees as a
percent of income for a family of three 
with one child in care, 2016

Source11

National Assessment of Educational
Progress (NAEP) fourth grade math and
reading scores, 2015

Source12

  • Sets the income eligibility limit for child care subsidies at or above 200% FPL [2016]11
    A family of three qualifies for assistance at $30,240 or 150% FPL. This reflects no change in the FPL percentage from 2015.
  • Reimburses center-based care at the highest quality QRIS tier at or above the 75th percentile of current market rates [2016]11
    The reimbursement rate for center care for a four-year-old in Miami-Dade county at the highest quality tier was 20% higher than the rate at the lowest quality tier.
  • Provides families with at least 12 months of continuous eligibility for child care subsidies [FY 2015]13
    Redetermination for families in TANF and protective services must be completed every six months. Each coalition must also conduct redetermination every six months for half of all other families receiving subsidies, using statistically valid random sampling to select families. Redetermination periods for the remaining families may vary by coalition, but must be completed at least every 12 months.
  • Funds a pre-kindergarten program and/or supplements Head Start [FY 2015]14
    $383,703,444 for pre-kindergarten
  • Requires districts to offer full day kindergarten [2016]15

State Choices to Promote Quality

  • Requires one adult for every four 18-month-olds, and a maximum class size of eight in child care centers [2013]16
    Child care regulations require one adult for every 6 children, and there is no maximum class size.
  • Has early learning standards or developmental guidelines for infants and toddlers [2016]17
  • Has an infant/toddler credential or certificate [2014]18
  • Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver [2014]19
  • Requires one adult for every ten 4-year-olds, and a maximum class size of 20 in child care centers [2013]16
    Child care regulations require one adult for every 20 children, and there is no maximum class size.
  • Has implemented a statewide Quality Rating Improvement System (QRIS) [2017]20
    Regional QRIS launched
  • Requires one teacher for every 12 students in kindergarten classrooms [2016]21
    Requires one teacher for every 18 students.
  • Has comprehensive, free-standing standards for social emotional learning at the K-12 level [2017]22

Parenting and Economic Supports

State Choices to Promote Effective Parenting

Low-income young children with a
parent employed full-time, 2015

Source3

  • Extends Medicaid coverage for family planning to otherwise ineligible low-income women [2017]23
    Eligibility for women losing coverage for any reason (in the past 2 years) and individuals younger than 19 years of age.
  • Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2015]24
    Parent must return to work when child is 3 months. Recipient may be required to attend classes or other activities.
  • Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2015]24
    Required to work 30 hours.
  • Has paid family leave for a minimum of 6 weeks with partial replacement of wages [2016]25
  • Offers accrual of at least five paid sick days [2016]26

State Choices to Promote Family Economic Security

Education levels of mothers with young
children, 2015

Source3

Maximum annual TANF benefit for a
family of three, for FY 2015

Source24

  • Established a state minimum wage that meets or exceeds $9.82/hr and is indexed to inflation for a family of three [2017]27
    $8.1
  • Exempts single-parent families of three below the federal poverty level from personal income tax [2014]28
  • Offers a refundable state Earned Income Tax Credit [2016]29
  • Offers a refundable state dependent care tax credit [FY 2015]30
  • Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2016]11
    Copayments set at 9% of income.
  • Offers exemptions and/or extensions of the TANF benefit time limit for women who are pregnant or caring for a child under age 6 [FY 2015]24
    A minor is exempt from the time limit if he or she has a child or if she is pregnant.
  • Offers a minimum of 28 weeks of Unemployment Insurance benefits [2017]31
    State provides up to 12 weeks of regular state-funded UI
  • Offers a refundable Child Tax Credit [2017]32
  • Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP [2016]33

  

Data Notes and Sources

Last Updated: September 5, 2017

Send us recent developments to update your state's profile.

  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. National data were calculated from the 2011 American Community Survey, representing information from 2011. State data were calculated from the 2009-2011 American Community Survey, representing information from the years 2009 to 2011.
  4. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2016). The Annual EPSDT Report (Form CMS-416) for FY 2015. https://www.medicaid.gov (accessed December 12, 2016).
  5. Brooks, Tricia; Miskell, Sean; Artiga, Samantha; Cornachione, Elizabeth; and Gates, Alexandra. 2016. Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed February 29, 2016)
  6. Brooks, T., Miskell, S., Artiga, S., Cornachione, E., & Gates, A. (2017). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2017: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed February 3, 2017).
  7. Ringwalt, S. (Comp.). (2015). Summary table of states' and territories' definitions of/criteria for IDEA Part C eligibility. http://www.nectac.org (accessed August 25, 2015).
  8. Kaiser Commission on Medicaid and the Uninsured. (2017). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed February 2, 2017).
  9. Smith, S., Granja, M., Ekono, M., Robbins, T., & Nagarur, M. (2017). Using Medicaid to Help Young Children and Parents Access Mental Services: Results of a 50-State Survey. New York: National Center for Children in Poverty, Mailman School of Public Health, Columbia University (accessed February 7, 2017).
  10. National Newborn Screening and Genetics Resource Center. (2014). National Newborn Screening Status Report. http://genes-r-us.uthscsa.edu (accessed March 24, 2015).
  11. Schulman, K., & Blank, H. (2016). Red Light Green Light: State Child Care Assistance Policies 2016. National Women's Law Center. https://nwlc.org (accessed December 14, 2016). Parents at 150% FPL ineligible in the following states: AL, AR, GA, ID, IA, MD, and MT.
  12. U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. (2015). National Assessment of Educational Progress (NAEP), 2015 Math and Reading Assessment. http://nces.ed.gov (accessed November 10, 2015).
  13. Stevens, K., Minton, S., Blatt, L., & Giannarelli, L. (2016). The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2015. OPRE Report 2016-94. 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 February 22, 2017).
  14. Barnett, W. S., Friedman-Krauss, A. H., Gomez, R. E., Horowitz, M., Weisenfeld, G. G., & Squires, J. H. (2016). The State of Preschool 2015: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed December 12, 2016).
  15. Parker, E., Diffey, L., & Atchison, B. (2016). Full-day kindergarten: A look across the states. Denver, CO: Education Commission of the States. http://www.ecs.org (accessed June 23, 2017).
  16. National Association of Child Care Resource and Referral Agencies. (2013). We Can Do Better: Child Care Aware of America's Ranking of State Child Care Center Regulations and Oversight. http://usa.childcareaware.org (accessed August 14, 2013).
  17. Administration for Children & Families, Office of Child Care. (2016). State/Territory Early Learning Guidelines. https://childcareta.acf.hhs.gov (accessed February 3, 2017).
  18. Administration for Children & Families, National Center on Child Care Professional Development Systems and Workforce Initiatives (PDW Center). (2014). State/Territory Infant/Toddler Credential Overview, April 2014. https://childcareta.acf.hhs.gov (accessed September 2, 2015)
  19. National Center on Child Care Quality Improvement & National Association for Regulatory Administration. (2015). Trends in child care center licensing regulations and policies for 2014. (Research Brief #1 ) (No. 314). Fairfax, VA: National Center on Early Childhood Quality Assurance. Https://childcareta.acf.hhs.gov (accessed June 23, 2017).
  20. QRIS National Learning Network. (2017). Current Status of QRIS in the States map. http://qrisnetwork.org (accessed February 7, 2017).
  21. Education Commission of the States. (2016). Early Learning: Kindergarten Online Database. http://ecs.force.com (accessed February 7, 2017).
  22. The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2017). K-12 Learning Goals for SEL in all 50 States. http://www.casel.org(accessed June 23, 2017).
  23. Guttmacher Institute. (2017). State Policies in Brief: Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed February 8, 2017).
  24. Cohen, E., Minton, S., Thompson, M., Crowe, E., & Giannarelli, L. (2016). Welfare Rules Databook: State TANF Policies as of July 2015. OPRE Report 2016-67. 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 December 7, 2016).
  25. National Conference of State Legislatures. (2016). State Family Medical Leave and Parental Leave Laws. Washington, DC: National Conference of State Legislatures. Http://www.ncsl.org (accessed November 28, 2016).
  26. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2016). 50-State Data, Family and Medical Leave. http://nccp.org (accessed July 18, 2017). *Original data were collected by the National Partnership for Women & Families.
  27. National Conference of State Legislatures. (2017). State Minimum Wages: 2017 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed June 23, 2017).
  28. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2014) 50-State Data, Income Tax Liability. http://nccp.org(accessed June 23, 2017).
  29. Williams, E. (2017). States Can Adopt or Expand Earned Income Tax Credits to Build a Stronger Future Economy: State Earned Income Tax Credits, 2016. Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed June 23, 2017).
  30. National Women's Law Center. 2016. State Child Care and Dependent Care, Tax Provisions, Tax Year 2015. Washington, DC: National Women's Law Center. https://nwlc.org (accessed December 6, 2016).
  31. Center on Budget and Policy Priorities. (2017). Policy Basics: How Many Weeks of Unemployment Compensation Are Available? https://www.cbpp.org (accessed June 23, 2017).
  32. Tax Credits for Workers and Their Families. (2017). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 18, 2017).
  33. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2016). 50-State Data, Supplemental Nutrition Assistance Program (SNAP). http://nccp.org(accessed July 18, 2017).