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In two previous , I wrote about how the child care “non-system” hurts its own workforce and the parents who enroll their children in it. Parking attendants and animal caregivers earn more per hour than the average child care worker, yet it’s more expensive for a parent to send a two-year-old to child care than a 20-year-old to public university in most of the country. The non-system can hurt workers and parents, and (surprise!) it can also be detrimental to children.

I first want to lay out the fractured nature of our non-system. There are roughly four categories of non-parental early care and education:

• Center-based programs
• Home-based care, a child care arrangement with multiple children in someone’s home
• Family, friend and neighbor care, an informal community-based arrangement
• School-based child care, run by a local education administration

Within these categories are licensed and unlicensed providers, listed and unlisted providers, and paid and unpaid providers. Some are associated with Head Start and/or state-funded child care or pre-K programs. Each state sets its own policies for how providers are licensed, registered, and listed, and what sort of accountability comes with this. The fractured network of providers makes it difficult to track quality and access to child care in any given community.

The comprehensive scans that do exist offer a window into the non-system. Several studies of early care and education settings in the US have found that . The 2006 National Institute of Child Health and Development’s study found that one in four infant care settings were characterized by “moderately” or “highly insensitive care-giving,” and three in four were “minimally” or “not at all stimulating.”

The prominence of low-quality care is alarming since we know that learning experiences in the earliest years of a child’s life are vitally important to his or her academic and social success in later years. One of the longer running , which tracked students for a full decade after leaving child care, found that teens who were in high-quality child care settings as young children scored higher on academic and cognitive measures, and were less likely to have behavioral issues than their peers who were in lower quality child care environments.

A is made of a combination of many factors. At a basic level, care needs to be physically safe, which includes environments monitored by fire, health, and safety inspections, and has other structural elements such as small class sizes with low adult-to-child ratios. Care environments should be warm, inviting, language-rich, and use age-appropriate curricula. The quality of caregivers and teachers is perhaps the most important factor. They should encourage high and consistent levels of interactions with and among children, be responsive to children’s needs and desires, and be well prepared to work with young children.

These basic characteristics of quality can be found in any of the four categories of child care environments described above, but they are more common in some settings than others. In the aggregate, center-based programs than home-based programs on measures of their use of curriculum, adult-child ratios, teachers’ education levels, and staff participation in professional development. Home-based programs on parents’ perceptions of a nurturing environment for children, and also their flexibility and affordability.

While it can be difficult to pin down the perfect combination of characteristics for high-quality child care, there are states and communities that engage in promising practices that actively promote multiple aspects of quality in early care and education.

Largely sparked by almost all states now use quality rating and improvement systems (QRIS) to track and monitor quality in early care and education. North Carolina is a unique example of how these systems can be Through the state’s “Star Rated License” system, which has been around since 1999, all eligible child care centers and home-based programs can earn a rating from one to five stars. A one star rating represents meeting the minimum licensing requirements. A five star rating signifies highly-qualified staff, low adult-child ratios, and a nurturing environment characterized by many interactions between adults and children. The state conducts onsite evaluations on education standards and program standards to determine these ratings. 

The star ratings are then tied to financial incentives and support for quality improvements. North Carolina gives , funded by the Child Care and Development Block Grant (CCDBG), to programs that earn more stars in its ratings system. Additionally, the state provides targeted supports in the form of grants and health insurance reimbursements to help with staff retention. Finally, they have set up a training pipeline for early educators. All of the state’s community colleges offer early childhood associate degrees, and financial support is available to educators through two programs: . By connecting its QRIS to financial incentives and creating a training pipeline for early educators, North Carolina encourages safe and supportive child care with high classroom and teacher quality. Other states would be wise to monitor quality in a comprehensive way, and may consider attaching funding to measures of quality.

While QRISs are helping to improve formal care in many states, the majority of low-income children and children of color continue to be served in informal arrangements and unlicensed home-based care. Supporting quality in these environments is essential to ensuring all children have access to high-quality care. A found nearly 100 organizations throughout the US aimed at training, supporting, and providing resources to home-based child care providers. In Mississippi, local trainers at the Nurturing Homes Initiative make biweekly home visits, evaluate quality, and provide personalized coaching to over 100 caregivers throughout the year. They also give resources to caregivers, and encourage them to provide information and advice to parents.

The Arizona Kith and Kin project, in operation since 1999, serves over 300 family, friend, and neighbor caregivers annually. The program aims to increase participants’ understanding of child development and health and safety issues by hosting training sessions, creating peer support networks, and providing equipment such as fire extinguishers, car seats, socket covers, and more. Mathematica’s analysis found that the program increased understanding of safety and child development among providers and induced them to make specific changes in the care they provide. Programs like these have the potential to impact the quality of care for many children.

There are also ways the federal government can help transform the child care non-system. In his 2014 State of the Union Address, President Obama proposed expansions to CCDBG child care subsidies so that they might reach an additional one million children by 2025. To receive these additional funds, states would have to submit plans explaining how they would monitor and promote the quality of child care providers. This promising proposal could encourage states to link subsidies with state QRIS systems, like North Carolina does.

While, no actions have been taken since Obama’s 2014 proposal,  Hillary Clinton is expanding on these ideas in her current campaign. She has detailed multiple proposals to promote access to high-quality child care. Like Obama, Clinton says she would seek to expand child care subsidies to reach more children, but she would also double the number of children eligible for Early Head Start (whose programs must adhere to strict quality standards or ) and the federal investment in home-visiting services such as the program. Additionally, she would aim to promote quality with legislation that helps the workforce earn higher wages. Clinton’s proposal is ambitious, but it represents an understanding of how important the earliest years in a child’s life are.

To place so many of our nation’s youngest children in care characterized as “insensitive” and “non-stimulating” is to place our future citizens and leaders at risk. Many recognize this; officials at the highest levels of federal government and grassroots organizations alike are working to ensure that more children and families have access to affordable high-quality care. The non-system– with its fractured regulations, wavering financial support, and diffuse network of providers– stands in the way of this goal. As policymakers consider how best to transform the non-system into a system, they would be wise to do so with the concepts of quality and access at the center of their actions. This would benefit children’s academic, social, and economic well-being, and make the future generation a stronger one.