Case Study: Care in New Mexico

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”I just wish it were a little bit easier”

The front door of Nora Nivia Nevarez’s adobe-like house in suburban Albuquerque opens to blocks and children’s books scattered around the brightly colored carpet, shaped like a puzzle piece. Children’s shouts can be heard in the backyard, as the children play on a slide during recess. Throughout the afternoon, she keeps a careful eye on her four small charges, ages four months to 10 years, by turns reading books, playing blocks, and helping them with puzzles. She periodically gets up to stir a pot of chicken noodle soup she’s preparing for the kids’ dinner, one of any number of meals and snacks she’ll make for the children she cares for every day. Nevarez works no set hours, but rather follows parents’ work schedules. That can mean days that start as early as 6 a.m. and last long into the evening. One little boy named Javier cries as his guardian, Guadalupe, picks him up. He’s tired, and ready to go home.

“I love caring for children, I just wish it were a little bit easier,” she sighs, speaking in Spanish. Nevarez, 50, has been taking care of children for decades. She began with her own three children, cared for her two grandchildren and now helps friends and neighbors as a registered family child care provider in Southwest Albuquerque, one of the many in the state. And truly, her work is a labor of love. She doesn’t turn anyone away. Javier is autistic and his guardian hasn’t been able to find anyone who will care for the child. Nevarez will.

Due to state regulations, Nevarez cares for no more than four children unrelated to her at any given point. She charges $2.00 per hour per child in her community, regardless of what families make, to help keep the cost affordable. That means, at best, she’ll earn $8.00 an hour to care for four children. But if she takes toddlers from low-income families receiving a state subsidy to help them pay for care, she may make as little as $1.58 per hour per child. That’s $6.32 per hour for four kids. Reimbursement rates for infants are slightly higher. But even with such paltry pay, she often doesn’t know from week to week how much she’ll earn, because the parents’ schedules are often erratic and sometimes the children need care for part of the week, and sometimes for all of it, and sometimes, to cover family overtime, even more.

But that Nevarez makes so little does not mean that families aren’t paying a lot. Parents are expected to pay the difference between the state’s full rate—based on child age, hours of care needed, and status of child care provider—and what the state chooses to subsidize based on parent income. And in Albuquerque, despite the long hours and low pay for Nevarez, her family child care home is actually a best-case scenario, if not for her, then for families. Like other registered providers, her family home meets basic health and safety standards. She knows CPR. She knows that infants should be put to sleep on their backs. And she’s gotten more training on developmentally appropriate activities and other measures of high quality care, so that she can become a licensed provider. That’s good for the families of her four charges. But many other families have far fewer options. And in a state where child poverty rates are the highest in the country and many working families struggle to make ends meet, many can’t find registered or licensed child care they can afford, so they move underground, into the “gray market” of often unreliable, unregulated family, friend and neighbor care.

Care Goes Underground

In gathering information on the cost, quality and availability of care, New Mexico, falling in the lowest quartile in the Care Index, stands out as a state struggling to provide affordable and accessible care—seeking to improve quality—and forced to make trade-offs because of the way the current system is set up. The Care Index found that the average cost of care in a center in New Mexico, $8,865 a year, is about 95 percent of the average rent, nearly 20 percent of the median household income, and would eat up more than half of a minimum wage worker’s income. About one quarter of all centers are accredited for quality.

New Mexico also mirrors many of the changing demographic trends of young learners: increasing numbers of dual-language learners who speak a language other than English at home. So why is it so difficult for families in New Mexico to find quality, much less affordable care?

Child care is expensive. Children under five require individualized care, attention, and learning, and 80 percent of the cost of child care are the teachers’ salaries. To reduce the cost of care to a lower—but still unreasonable—level, most caregivers in New Mexico, and across the country, are paid poverty wages. This is reinforced by the state, which reimburses caregivers like Nevarez at a fraction of the cost of providing care. As a result, in 2015 nearly half (46 percent) of the child care workforce across the country relied on public assistance. In their most recent study of the early childhood workforce, University of California Berkeley researchers Marcy Whitebook, Caitlin McLean, and Leah J.E. Austin found that, in New Mexico, child care workers are in the third income-percentile—nearly the lowest of all paid workers—and get few to no benefits. The median hourly wage is $9.10, a four percent decrease since 2010. Inadequate pay results in high attrition and turnover. Places that do provide adequate pay, and have low turnover rates have to rely on outside donations, in addition to private tuition paid by parents, and government funds, to survive.

Catholic Charities is one of those providers. “We can’t fully address child development without losing money due to the cost of quality staffing, staff development, and safe facilities,” said James Gannon, CEO and executive director of Catholic Charities in the Archdiocese of New Mexico. “Catholic Charities assesses community need, provides services, and covers the shortfall later. It’s not economically sustainable.”

In their South Valley child development center, Catholic Charities provides services to 47 children, running an annual deficit of roughly $250,000. The reason? They invest in the teachers in order to provide high quality care. “We pay our staff $13.00 per hour, provide health care, time-off, and a retirement plan,” Gannon explained.  

Child care is a double-edged sword. Because the majority of children are raised by working parents, not accessing child care is not an option. To those who are unemployed, a lack of child care creates a barrier to reducing poverty, family income, and a steady job.

Yet even after attempting to provide “low-cost” care to families, the cost is still too high relative to income. In the case of New Mexico, families have limited means to contribute to expenses such as child care—30 percent of children live in poverty, the highest rate in the U.S., and 56 percent of children receive public health insurance in the form of Medicaid and the Children’s Health Insurance Program (CHIP). As recently as August 2016, New Mexico Cabinet Secretary Monique Jacobson estimated that child-Medicaid eligibility was as high as 80 percent. Child care is a double-edged sword. Because the majority of children are raised by working parents, not accessing child care is not an option. To those who are unemployed, a lack of child care creates a barrier to reducing poverty, family income, and a steady job.

In New Mexico, availability of child care is also related to the cost issue: Demand for formal care dwindles because families can’t pay for it, and child care workers leave the industry because they can’t make enough money. Finally, the inability to retain workers makes quality difficult to achieve—the industry can’t retain the workers they do successfully train.

All this is to say that the high cost of care often pushes people to rely on informal family, friend, and neighbor networks and family child care providers like the still-underpaid Nevarez. But since people are opting out of any formal system, we know increasingly little about the safety and quality of children in such settings. Is the care loving, warm, and developmentally appropriate? Or are kids are just plopped in front of a television set? There’s no way to know.

Meet Amy Bazan

Amy Bazan had her first child—a daughter, Alexandria—when she was 19 years old. She faced the daunting task of finding child care while tackling a pre-med course load. In her first week of care, Alexandria fell off a concrete step and hit her face. Bazan remembers:

“Children fall all the time. What was scary is that they didn’t call to let me know what happened and didn’t give my daughter first aid for the gash. At pick up, I saw my daughter’s bloody face and the caregiver didn't have any information about what had happened.”

She took her out of that center and found another. At the second center, her daughter’s pinky finger got smashed and nearly pinched off. Alexandria would scream and cry when she dropped her off, so Bazan gave up on the second center as well. She eventually found New Mexico’s child care resource and referral line and a family child care provider she felt comfortable with. When her caregiver went back to school, the caregiver suggested Bazan take over the  business and open a family child care program herself so as to both earn money and meet her own care needs for Alexandria.

After running her own family home program for three years and working across the child care system, in 2014 Bazan was named director of the Providers Allied for Nutrition program– a USDA Child and Adult Care Food Program (CACFP) program. Nicknamed PAN after the Spanish word for bread, the YWCA program provides family child care providers, including Nevarez, with money and information about safe cooking, healthy eating, and community resources. Over the last 15 years, Bazan has watched the type and number of providers dwindle. Under the current system, attempting to provide high quality care that’s affordable and easily available for parents is a lose-lose situation, Bazan said. From the other end of the proverbial telescope, she joins Nevarez in wishing it were just a little bit easier.

Family child care homes are mostly unregulated—technically “legally exempt” from New Mexico health and safety regulations—except for when providers register and participate in subsidy programs, the largest of which is CACFP. This means that, to really understand family home care, you need to understand federal food and nutrition programs.

What little information we have is limited to registered and licensed family child care homes. The licensing and registration unit of the New Mexico Children Youth and Families Department inspects licensed family child care homes a minimum of twice per year, registered family child care homes annually, and food sponsors visit two to four times per year. Nevarez is one of those registered—and inspected—New Mexico providers participating in the food program. If providers are not in compliance with licensing standards, providers will receive additional inspections until they are found “in compliance” or given a sanction. Alternatively, providers may reduce the number of children in their care, opt out of registration or licensure, or receive a fine, thereby losing state food or assistance subsidies. Cease and desist notices are issued to stop all daycare when a provider is found to be caring for more than four non-residential children. But according to Henry Varela, communications director for the New Mexico Children, Youth and Families Department, non-compliance numbers are not tracked. Moreover: “We are unable to prevent a provider who did not meet the qualifications to become licensed or registered from babysitting up to four non-residential children. It is through educating parents on how to select quality child care that we encourage them to select registered or licensed providers to care for their children,” said Varela.

The New Mexico Child and Adult Care Food Program (CACFP)

In the 1960s, increasing numbers of people were watching kids not their own, and having to feed them across the day. In 1968, the U.S. Department of Agriculture recognized the need to support caregivers and working families, and thus sponsored a pilot program to reimburse caregivers for the meals served while caring for the children, and provide nutritional information and education. Section 17 of the 1976 National School Lunch Act (42 U.S.C. 1766) made the program permanent and today, CACFP funds meals for 3.3 million children in child care across the country as well as technical assistance for quality day care and nutrition improvements.

The program is funded by the USDA and administered by states. The New Mexico food program is run through the family nutrition bureau of the New Mexico Child, Youth and Families Department (CYFD). CYFD contracts community providers—nonprofits—to visit family child care providers, which is how the YWCA got involved. In New Mexico, there are 15 nonprofit food program sponsors, including the YWCA, that work with child care providers in their home. Nutrition programs are therefore a main vein of the caregiving landscape, touching a wide swath of care providers.

A Gray Market for Care

When Bazan started with PAN in 1994, the food program helped close to 1,200 registered family child care home providers out of 7,000 statewide. Now they help roughly 250 out of 2,000 statewide. The number of licensed providers is a small fraction of the number of registered providers, which is a fraction of the number of unregulated gray market providers as a whole.

“In the last two years alone,” Bazan said, “I’ve watched the food program lose 30 percent of homes and go into rapid decline.” Loren Miller, CACFP manager for the (statewide) Family Nutrition Bureau of the Children, Youth and Families Department (NM), confirmed that between November 2013 and July 2016 alone, the state witnessed a decline from 3,117 to 2,151 providers. In Bazan’s experience, people are still providing care and simply forgoing government programs and regulations, be it the food program, registration, and/or licensing, because complying is too costly, time-consuming, and invasive. As a result, the number of children needing care in New Mexico outpaces the number of known child care slots.

That doesn’t mean the children aren’t ending up somewhere.

Who’s Watching the Kids?

Family, friend and neighbor care, as well as family child care homes like Nevarez’, offer particular strengths and challenges. In New Mexico, people are legally exempt from health and safety child care laws if they care for four or fewer children unrelated to them. Since most family, friend and neighbor care and family child care centers are small and unregulated, there are no consequences to providing unsafe or low-quality care. Often, no one knows about the overcrowded or unsafe under-the-table care arrangement unless tragedy strikes. And even for regulated care, there is no one body “enforcing” safe or developmental standards. States have varying health and safety standards and spotty inspection cycles. The federal government only recently added health, safety and quality standards for all providers through the Child Care and Development Block Grant, but they apply only to child care centers and family child care homes that accept children on subsidies. All of which is to say, we know little about the health and safety of many family child care homes, family, friend and neighbor care, and even less about the content of what children are learning.

The Perfect Storm

Which brings us back to Bazan and Nevarez. When Bazan became a child care provider, her experience with the food program and associated technical assistance was very supportive and helpful: “They made following the rules easy,” she said. They helped her comply with child care regulations and supplement her knowledge with free nutrition and child development training. Bazan was a registered provider with the PAN food program until her daughter turned five. When her daughter entered school and her child care needs changed, Bazan’s food program monitor asked if she'd be interested in a position as a field representative of the program. Bazan registered and monitored family home providers for eight years, and then worked as a child care professional development specialist on quality improvement in accordance with New Mexico’s quality rating system. Bazan worked her way up to a management position as she received her Master’s in education (2012) at the University of New Mexico. Having gained years of experience across the child care spectrum, she returned to PAN as the new director in 2014. Between 1994 and today, she’s watched the hurdles of finding and receiving quality child care increase.

Nevarez, meanwhile, was the primary caregiver for her children and grandchildren. But as her children aged out of care, she began to care for other children in her neighborhood and community. I connected with Nevarez through the Partnership for Community Action (PCA), which helped her pursue an early childhood certificate from the Central New Mexico Community College and become a registered provider with the food program. Founded in 1990, PCA works to develop the capacity of parents to be advocates for early education, develop relationships with their service providers, and help them become strong leaders at the local and state level. Yet despite her desire to provide enriching care for her students, and become not just registered, but licensed, which will enable her to care for more children and receive a higher subsidy rate per child, she’s facing the perfect storm of bureaucratic changes.

“It used to be that the food program operated as a one-stop shop for ensuring food, health, and safety of children in family child care homes, as well as registering providers and offering information on child development,” said Bazan. However, this all changed in October of 2013, when the USDA imposed a new requirement which stipulated that home sponsoring organizations were not allowed to complete the registration process and give approval to operate as registered homes. The memo requires sponsoring agencies—such as the YWCA—to focus solely on what's being served and food sanitation, not health and safety or child development: “State agencies may not require CACFP sponsors to monitor a facility’s compliance with State or local licensing requirements or report licensing violations to the State licensing agency.” Shortly thereafter, the government of New Mexico created a separate department to monitor the food program. New Mexico food monitors—including Miller and Bazan—attribute changes in monitoring to this rule. Now nonprofits such as the YWCA monitor the food program, and a second, different department housed in CYFD manages the registration and licensing process, which has become labyrinthine.

Today, family child care home providers like Nevarez must deftly navigate the following steps to become registered. The family provider must:

  • Order or physically pick-up the relevant paperwork at CYFD between 8 a.m. and 5 p.m., during the very same hours that they need to be providing  child care.
  • Access a computer or phone for registration and fingerprinting ($44).
  • Send all documents to Santa Fe within a given time frame.

Meanwhile, everyone over 18 in the provider’s household has to pass the background check or the provider will not be eligible for registration or licensing. This is especially sensitive for families that are or know undocumented persons, and/or families with members who were formerly incarcerated. In the case of a failed home inspection, CYFD issues a survey report of what needs to get corrected in order to proceed with the registration or licensure process within 30 days. If approved, a clearance letter is offered and providers must call CYFD to schedule a home visit ($15). Throughout this process, family child care centers are subject to random visits.

Registered and licensed family child care providers are now becoming the exception. Most are not participating in the food program, or getting registered or licensed to provide care.

It is costly, time-consuming, and nearly impossible to comply—especially if providers must personally run these errands during child care hours and if they don’t speak English. Registered and licensed family child care providers are now becoming the exception. Most are not participating in the food program, or getting registered or licensed to provide care.

Which puts New Mexico back in the gray zone.

Caring about Care

After months of paperwork, Nevarez finally received her provisional child care license and can now care for six children at a time. If she passes her final inspection, her new license for a two-star, licensed family child care home will be issued for a full year. Licensed providers are paid $2.67 per hour for toddlers receiving subsidy, or $16.02 for six children—a meaningful raise from the rate for registered providers.

It’s the end of the day, and Nevarez begins to help the children gather their artwork and pack their small backpacks. She reflects on how much she’s learned as she’s sought to improve the quality of the care she provides and obtain a license, and how important that’s been for the children, despite the bureaucratic nightmare.

“I wish I had known more about child learning when I raised my children and grandchildren. I know so much more now,” she said. Research has found that children who speak a language other than English at home, like Nevarez’ charges, particularly benefit from high quality early care and learning; it promotes their early literacy, numeracy skills, and English language development. Bazan echos that sentiment, having just helped a friend look for child care: “I’m now more knowledgeable and picky. Finding child care for her [Bazan’s friend] was such a challenge. She’s found a home provider and paying $1,000, which is about her mortgage payment.”  

That’s a steep price. As Bazan and Nevarez both know, however, in New Mexico, providing care doesn’t come cheap for caregivers or the families who turn to them. Nevarez fastens the straps on Javier’s backpack as the children begin to leave at the end of the day with their parents. She stands in the doorway and waves goodbye.

Correction 11/22/2016: Nora Nevarez graduated from Central New Mexico Community College, not the University of New Mexico, as previously stated.