Case Study: Care in Georgia

Photo: Long Story Short Media

“I Couldn’t Afford to Work, and I Couldn’t Afford Not to Work”

It’s 6:45 am on a Monday morning. Monyatta Carter has already been up for over an hour, getting herself ready for work and feeding the family’s four dogs, one floppy rabbit, and the fish scattered in the 11 aquariums that line the living room and front hall of their rented house in Conyers, Ga. She’s started a load of laundry, found the lid to her husband’s coffee cup, packed two tiny pink backpacks emblazoned with the cartoon princesses of the Disney movie Frozen, dressed the baby in a red Minnie Mouse tank top with bright blue leggings, and is struggling mightily to get three-year-old September out of her bedroom.

“I don’t wanna go to school!” the child wails, her legs locking. Carter balances 17-month old Temi on her hip, plastic bowls of grapes and strawberries for the girls to eat in the car in one hand, and, with the other, pulls September down the carpeted hallway toward the front door.

“I know,” Carter says evenly. “But you know we gotta go, Sprout.”

Throughout the morning routine, Carter constantly checks her smartphone to keep track of the time. To get to work by 9 a.m., drop the girls off at their family home care center, about 15 miles away, and drive another 20 to get to work, Carter has to be pulling out of the driveway no later than 7:30 a.m. If she’s lucky and the traffic is light, she’ll sometimes stop at the McDonald’s drive-through for a cup of coffee for breakfast.

Carter, 39, works in Decatur as a medical coder for Emory Healthcare. When she began looking for early care and learning, she wanted the girls close to her work in case of emergencies. Their care is primarily her responsibility. Her husband owns his own mobile detailing business and has an unpredictable schedule. Her extended family lives miles away in South Georgia. And her three older children from her first marriage are busy working and going to college.

Her first choice was her own employer’s on-site child development center, one of the best in the area, and only three minutes from her office. But she despaired when she discovered it was going to cost her about $1,840 a month, or $22,000 a year for an infant and toddler, even with her employee discount. That’s more than her rent and about as much as she takes home. She debated staying home. But her job provides not only steady income, but also the family’s health insurance. “I couldn’t afford to work. And I couldn’t afford not to work,” she explains as she wrestles the girls into their car seats, checks the time on her phone, and hurriedly brushes an unexpected army of ants out of the car.

"I wanted more than just a babysitter. I want my girls to have individual attention. I want them safe. I want them to learn. I want someone to be accountable if something happens. And I want to be comfortable where I leave my kids, and not worry about them while I’m at work.”

She began searching for licensed, high-quality care as close to her office as she could find. And the closest place that she felt was a good fit and that she could afford was 20 miles away, in a small family child care home that takes no more than six children at a time in Lithonia, about halfway between her work and her house. Care for the two costs $13,440 a year. But a small, privately-funded “Boost” scholarship, run by Quality Care for Children, an Atlanta-based nonprofit, to help low-income families get ahead, is picking up about $3,000 of that for now. “That has helped the family budget tremendously. I didn’t want to have to choose between paying for child care and paying for food,” she explains. “But I wanted more than just a babysitter. I want my girls to have individual attention. I want them safe. I want them to learn. I want someone to be accountable if something happens. And I want to be comfortable where I leave my kids, and not worry about them while I’m at work.”

After a winding drive on backroads, September now chattering happily, Carter pulls into the driveway of a cheerful yellow clapboard house with a small addition on the side. She untangles the girls from the car, gingerly carrying Temi, who’s fallen asleep, and knocks on the little green door. As she hands the girls over to the home care provider, a smiling Antoinette Elliott, Carter braces for tears from Temi. It always breaks Carter’s heart when the baby cries as she leaves. She takes a deep breath. Next year, she thinks. Next year, September will be four, and she’ll enter the lottery in the hopes of getting one of the slots in Georgia’s free universal pre-K program. The morning commute may be worse, taking the girls to two different places, but the break on the family budget will be a relief. Carter checks her phone again for the time. Traffic will be piling up. It’s time to get to work.

What to Do About the Babies

Monyatta Carter’s struggles with early care and learning are hardly unique. In interviews with dozens of families across Georgia, parents shared stories of how they are forced to make choices between cost, quality, and availability every day when it comes to finding care for their children. Moreover, those difficult trade-offs often shape their lives and can determine the course of their children’s futures.

The inability to find or afford quality early care is the reason why some families, like Jaime White’s, decided not to have more children, even though they’d hoped to. Already, the Whites pay $44,000 a year, more than their mortgage, to ensure their children have high quality care. The lack of early care is why parents in some families, like Ashley Henderson’s, work split shifts and rarely see each other. The lack of early care is why some parents, typically mothers, dropped out of the workforce, even though they didn’t want to. “Child care can affect the direction of your whole life, the unattainability of it. It certainly has for me,” said Michelle Cawley Burg of Lilburn, who reluctantly quit her job when she had no paid family leave and couldn’t afford child care. Ten years out of the workforce and five children later, she’s starting all over again.

Caree Jackson Cotwright, a professor at the University of Georgia in Athens, faxed the university’s on-site child development center the day she gave birth to her first daughter to get her on their waiting list. “And it’s not because I’m crazy,” she said. “That’s normal.” She felt lucky to get a spot six months later.

For many struggling families, like single mother Raysean Hawkins, a patient care tech who lost her child care subsidy after picking up an extra 12-hour shift to better provide for her two children, the lack of affordable, high-quality early care can keep parents stuck and unable to climb the economic ladder. Hawkins dreams of going to college to get ahead in life. But Georgia is one of eight states that do not help low-income parents offset the cost of early care if they’re enrolled in a four-year college program or two-year associate degree program. For children, research has found that a majority of the achievement gap at age 14 was already present on the first day of kindergarten, and that the disparity in cognitive skills at age four between low- and high-income children in the United States is already among the largest in all of the advanced economies. “How can you get up the financial ladder when you’re constantly being pulled down?” Hawkins says. “Child care is crazy.”

“How can you get up the financial ladder when you’re constantly being pulled down?” Hawkins says. “Child care is crazy.”

And Georgia, compared to other states, does early care and learning pretty well.

In the Care Index, a data and methodology collaboration between New America and, Georgia ranked in the second quartile, 18th out of the 50 states, scoring in the top 15 on quality and availability, but falling to 31st in terms of affordability. Though quality is difficult to measure, 11 percent of centers and family homes in the state are nationally accredited for quality. The Care Index found that the average cost of full-time infant care in a child care center or family home center outstrips the average cost of in-state college tuition and fees in the state. For a family earning minimum wage, the average cost of child care in a center for all children under five eats up more than half their income. Nanny care, the Index found, runs $27,729 a year, more than two and a half times the average rent in the state.

What Georgia does well, however, is its early and pioneering embrace of early childhood education. Georgia was among the first states, along with Massachusetts and Washington, to create a stand-alone Department of Early Care and Learning.  “We don’t talk about daycare here,” one state official said. “We talk about early learning.”

Both Democratic and Republican governors have campaigned on and later supported the expansion of one of the first universal pre-kindergarten programs in the country. The state has invested more than $6 billion in state lottery funds over 25 years to make high quality pre-K available to 1.4 million children. Though demand still outstrips a supply—between 5,000 and 8,000 children sit on the waiting list every year—the system currently serves more than 80,000 children annually, or nearly 60 percent of the state’s four year olds. That falls just short of the universal pre-K programs in the District of Columbia, Vermont, Oklahoma, and Florida that reach more than 70 percent of their four-year populations. But it far outstrips others: 12 states serve less than 10 percent of their four-year-olds, and seven states have no pre-K program at all.

That investment in pre-K in Georgia is paying off. Researchers contracted by the state have found that children from all backgrounds are benefitting from the program, making gains across all domains. And that those who don’t speak English at home, a fast-growing population, begin the year with lower skills than their English-speaking peers, but learn at a faster rate and make large gains throughout the year.  “And those gains tend to continue beyond the pre-K program,” said University of North Carolina research scientist Ellen Peisner-Feinberg, who is studying a representative sample of Georgia children from pre-K through third grade.

“I don’t think that early learning is a partisan issue. It’s a bipartisan issue. I think how you pay for it is a partisan issue. And we’re working on that here in Georgia.”

Further, a 2015 study of the economic impact of child care in Georgia found that it is a $4.7 billion a year industry, on par with the pharmaceutical and the hotel/motel sectors, creating nearly 85,000 direct and indirect jobs, serving 337,000 children and enabling more than a half million parents to work each year and pay taxes on $24 billion in income. “Legislators and business leaders now see that the child care industry is an important economic driver in the state,” said Amy Jacobs, commissioner of the Department of Early Care and Learning for Republican Gov. Nathan Deal. The economic impact data got both Republican and Democratic lawmakers’ attention, she said. Now, the brain research showing that in the first few years of life, a child’s brain is making 700 to 1,000 critical new neural connections every second, forming the foundation upon which all later learning will be built, is pushing lawmakers to take action. “You can’t dispute that research. And I think Republicans and Democrats are starting to listen,” Jacobs added. “I don’t think that early learning is a partisan issue. It’s a bipartisan issue. I think how you pay for it is a partisan issue. And we’re working on that here in Georgia.”

But that also gets at the heart of the current struggle in Georgia: what to do about the babies.

The cities of Atlanta and Marietta, along with major employers headquartered in the state, like Home Depot and Coca Cola, offer paid family leave to new parents. But most workers in the state, as in the rest of the country, get little or no paid family leave and new, adoptive, and foster parents must either use their own vacation or sick time, take unpaid leave, or seek child care and return to work within weeks of the baby’s arrival. Nearly one in four mothers, one investigation of a Department of Labor survey found, return to work within two weeks.

In Georgia, as in the rest of the country, infant care is hard to find, often wildly expensive and, a 2009 state study found, pretty bad. Nearly 70 percent of all licensed infant and toddler classrooms in Georgia were rated as low quality, with children in environments “inadequate for their health and safety” that “do not promote their cognitive and social-emotional development.” And though the care was that bad among licensed providers, the state has no idea about the experience of children in small, unregulated settings—people may care for up to two children unrelated to them for pay without needing to obtain training or a license—or on the cheaper “gray market” of informal care provided by family, friends, and neighbors.

“That was a real clarion call for us,” Jacobs said.

With a $51 million federal Race to the Top grant through the end of 2017 and an additional $14 million raised from the private sector, the state has a new plan to boost the quality of infant and toddler programs through efforts like creating the Quality-Rated Improvement System, giving more generous subsidies to low-income families who choose higher-rated child care establishments, and offering scholarships to teachers to seek more training—the key to quality care. In addition, the governor added $25 million from state lottery funds in May 2016 to raise pre-K teacher salaries and bring them more in line with K-12 teachers.

The plan, however, does not call for raising the salaries of teachers in infant and toddler classrooms. Nationally, those who teach infants and toddlers make about 70 percent of what those who teach three- and four-year-olds make. Which is little enough. In Georgia, the median wage for all early childhood workers, $9.16 an hour, hasn’t changed since 2010, and more than half of workers’ families are on some form of public assistance. Nannies in the state make slightly less than the national average of $13.92 per hour, the Care Index found, but typically have no benefits like health care, advocates said, and are often expected to take on more chores without additional pay, and have no recourse if they’re fired.

Georgia is also using the federal funds to increase the availability of quality infant and toddler care in rural counties, called Early Education Empowerment Zones, where the need for licensed, quality infant and toddler care far outstrips what’s currently available. In Clark County, home of the University of Georgia, the current system can only serve 27 percent of the children ages 0-4 who may need care. In Brooks County, it’s less than 5 percent.

In addition, the state is also revamping its child care subsidy program with an eye to increasing quality for disadvantaged children in an effort to boost school readiness, close the achievement gap, and reduce inequality. In a plan approved in May 2016, the state is lowering the amount low-income working families have to pay out of pocket, a move that will mean strapped Georgia families will no longer pay among the most for care in the nation. Georgia is also raising the rate it reimburses high quality centers for accepting children who qualify for subsidies—up to the 75th percentile of the 2013 market rate for care. (Although the cost of early care and learning nationally has risen every year—at nearly twice the rate of the price for all other consumer goods—the state had been setting reimbursement rates based on a fraction of what early care and learning cost in 2007.) Advocates say that will mean high quality centers will be more likely to accept more children from economically disadvantaged backgrounds. And that’s a good thing.

But the bad thing is that the increased spending on quality and affordability means, without additional substantial investment, the state will be cutting availability to as many as 17,000 children a year. “It’s like, in a flu epidemic when you have limited vaccines. Do you give watered-down flu vaccines to the whole population, where it may not do the trick, or do you give the recommended dosage to a smaller number of people?” said Mindy Binderman, an advocate with Georgia Early Education Alliance for Ready Students. “It’s a really hard trade-off.”

And with so far to go, so much at stake in the early years, and the federal grant expiring soon, parents, advocates, and providers worry that lawmakers in the fiscally and culturally conservative state will fail to act. Outside the roughly $300 million in state lottery funds for pre-K every year, Georgia invests about $50 million annually—to match the federal government’s $200 million—to help make early care and learning more affordable for about 50,000 children from low-income working families, even though that represents only a fraction of the nearly 700,000 children under age 13 living in such families. (Unlike 12 other states, Georgia does not add state dollars to the federal Head Start preschool program.) Many lawmakers see early care and learning as the private responsibility of families, advocates said, not a public good to invest in. “Honestly, many legislators come from a different era in which mama stayed home with their babies, so they think that is where they belong,” said Carolyn Salvador, executive director of the Georgia Child Care Association. “You’ve got to overcome old ideas that this is not early education, but just glorified babysitting.”

The Market Just Doesn’t Work

From his office window on the 38th floor in the soaring One Atlantic Center skyscraper in Midtown Atlanta, Aaron Block, a corporate lawyer for the international law firm Alston & Bird, can see his three-year-old daughter Mary Jane’s child development center. The law firm is one of the few employers in the country that offers subsidized, high quality on-site early care and learning to its employees—just two blocks away. And unlike in most centers, where turnover is high and quality low, many of the well-trained and well-paid teachers have worked at the bright, airy Children’s Campus since it opened in 2001. “There’s this feeling of community that you get from being at a child care center that’s associated with the firm,” Block said. In fact, on-site care was a big draw when he decided to accept the job in 2010, even though that was before he and his now-wife were even married.

The same was true for reference librarian Toral Doshi, whose son Kieran is in Mary Jane’s class. “I’ve never had a moment’s hesitation about leaving my son at the center,” she said. “And a lot of it has to do with the fact that the teachers, they do become your family…someone that you know and trust and that your son loves and that they love him.”

Aaron Block drops Mary Jane off in the morning at the campus, which is operated by Bright Horizons, the largest provider of employer-sponsored early care and learning in the country. He can pop over for her dance recitals a few hours later, or sign up to read to her class. “During the day, I can be more productive and focused at work because I know that she’s in a place where she’s safe, where she’s happy,” he said. “When I’ve had a tough or demanding day, it really helps to look out the window and be able to see my daughter’s child care center, and know that she’s there having a fun time. Because ultimately that’s why I’m working hard.”

To build a robust early care and learning infrastructure, where all children develop strong attachments to well-trained teachers and are exposed to rich language nutrition to build the brain architecture for future learning, health and development, where parents can easily find affordable, high-quality care, and well-trained teachers and providers can make living wages, economists like Stanford University’s Myra Strober argue that it will take not just parents, but business and government support. Nationally, parents shoulder about 60 percent of the cost of early care and learning, one study found, federal, state, and local governments 39 percent, and businesses and philanthropic organizations just one percent.

“The economics for child care are the same as for K-12 education: There is no education that isn’t subsidized. Public education is fully subsidized by the government, and private education is subsidized by private gifts from alumni and the tax system,” she said. “But the way child care is setup now, the market just doesn’t work. Parent tuition alone simply cannot cover the cost of services.”

When it comes to business support for early care and learning, about 61 percent offer employees Dependent Care Assistance Plans to help them pay for care with up to $5,000 pre-tax dollars a year, according to the 2014 National Study of the Employer. Which is a drop in the bucket compared what parents typically pay. The Care Index found that the average full-time cost for center and family home care for children aged 0-4 ranged from a low of $5,720 a year in Arkansas to a high of about $15,856 in Washington, D.C. In Georgia, costs run about $8,569 a year. (Average full-time nanny care costs between $26,000 and $33,000 a year.) Only 2 percent of companies actually provide employees with vouchers or subsidies that are a direct cost to the company. And only 7 percent offer on-site, or near-site child development centers, down from 9 percent in 2008.

But in Georgia, Alston & Bird is only one of a number of larger employers offering on-site care and learning. Home Depot, Aflac, Turner Broadcasting System, Wellstar, Georgia Power, Georgia Pacific, and others do as well. One big reason is that Georgia is one of a handful of states that have passed tax incentives to help defray the cost of building and running on-site centers. Alston & Bird was able to write off 100 percent of the $4 million cost of building the center over 10 years, explained Hillary Bowers, senior benefits coordinator for the firm, and they can write off 75 percent of the annual operating cost.

“The cost of child care is something that the firm recognizes can be a huge burden on families, not just in Atlanta, but nationwide,” she said. The firm subsidizes the cost of care for the 70 children in the center, so parents pay below market rates, and offers scholarships for certain employee families who need additional help covering the cost of care. Now, in addition to expanded paid parental leave, breastfeeding rooms, and other family-friendly benefits, Bowers said the firm sees the Children’s Campus as an important tool for recruiting and retaining good workers and creating a positive company culture. “Our philosophy at Alston & Bird is that if we take care of our people, they will take care of our business. That is just the simplest business case there is.”

“I Honestly Don’t Know How Some People Do It”

At the end of a long day of work at a small sports marketing firm, a very pregnant Micki Velmer is driving to pick up her three-year-old son, Burke, from the Frazer Center, a child development center, when her car overheats and breaks down. Although Velmer’s husband, Jason, who works in digital marketing, soon swings by to get her and then get both of them to the Frazer Center before it closes, Velmer is uneasy.

Finding quality early care and learning that they could afford for Burke was difficult enough. She and Jason began looking when she was barely pregnant with Burke, toured child development centers, put down several deposits, and made regular phone calls to check in for months, “like it was another part-time job,” she says. But by the time Burke was born and she had cobbled together 12 weeks of short-term disability, vacation, and unpaid time off—she had no paid family leave—nothing had opened up. There were a few informal “Mom’s Morning Out” programs, but they only lasted a few hours. In a panic, the couple began to share a nanny with neighbors. But when both families moved to safer neighborhoods with better public schools, Velmer snapped up a part-time spot for Burke at the Frazer Center. He was nearly one year old. Now that he attends full time, they pay about $1,375 a month for his care, plus fees. With the new baby on the way, they’ll soon be paying another $1,450 a month. (Some centers in Atlanta that they looked at but ruled out as too expensive charge as much as $1,800 a month for infant care.) The cost of two children in full-time care will be more than the mortgage on their tidy ranch house in Druid Hills, one of the more affluent neighborhoods in Atlanta. Now, she worries, is not the time for expensive car repairs.

Because infant slots are so hard to find—in Atlanta, in Georgia, in the United States—the Velmers’ baby will be enrolled and they will actually start paying tuition a few days before the baby is even born. And they’ll continue to pay throughout Velmer’s 12-week parental leave. This time, working for a new company, she gets two weeks of paid parental leave, which she’ll extend with other paid and unpaid time off, and short term disability. Jason, who works for a French company, will have four weeks paid parental leave. All the while, they’ll be paying $4,350, plus deposit, just to reserve their baby’s spot.

Velmer has her concerns about the Frazer Center. She loves the diverse and inclusive special needs community; how the center is tucked into the woods with walking paths and gardens; and that it’s only one mile from their house. But, every year, the teacher turnover has been high. Not one of Burke’s teachers has made it through an entire school year, which she worries has disrupted the continuity of care, so critical for a child’s healthy development, despite the high price tag. But, just like Monyatta Carter waiting for her daughter to turn four and the financial relief of Georgia’s universal pre-K program, Velmer hangs on at the Frazer Center because, if Burke stays, he’ll be guaranteed a free pre-K spot. Then she’ll only need to pay about $75 a week for after school care. If they remove him, they can enter the lottery and take a chance that he’ll get one of the universal pre-K slots at a nearby public school or another private or nonprofit center. But that’s no guarantee. The competition in Druid Hills for the limited pre-K slots is fierce. “It just seems like a big gamble,” she says.

“Child care is tough,” Velmer said. Even for those, like she and Jason, with good jobs and savings. “I honestly don’t know how some people do it.” She does know that costs like early care and learning  are a big reason that, after their second child is born, she and Jason will never likely have more. “We’d always said we’d have two or three, but the financial piece is so scary.”

Velmer slowly walks into Burke’s classroom at the Frazer Center, where the children sit in a circle on a colorful carpet listening to one of the new teachers read a story, while Jason stays in the car and calls a mechanic and tow truck. The little boy’s eyes light up when he sees his mother, and he rushes to crush himself against her huge belly.

“Hey Bud,” she says softly, brushing the soft blonde hair from his forehead. “Have a good day?”

“Yeah,” Burke says, not letting go.

“You ready to go home?”

The boy nods. They walk toward the car, hand in hand.