Young children (under age 6)3: 434,422
* 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.
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 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 and Development
Sets the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) 5
- Children <1 year
Sets eligibility at 305% (S-CHIP) and 201% (Medicaid)
- Children 1-5 years
Sets eligibility at 305% (S-CHIP), 155% (M-CHIP), and 148% (Medicaid)
- Children 6-18 years
Sets eligibility at 305% (S-CHIP), 155% (M-CHIP), and 148% (Medicaid)
- Pregnant women
Sets eligibility at 305% (CHIP and Unborn Child Option: CHIP-funded) and 201% (Medicaid)
- Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period 5
- Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period 5
- Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined 5
- Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined 5
- Extends Medicaid coverage for family planning to otherwise ineligible low-income women 6
Missouri operates an entirely state-funded program that provides family planning services to women at least 18 years of age with incomes up to 185% FPL. Women losing Medicaid postpartum are also eligible.
- Includes at-risk children in the definition of eligibility for IDEA Part C 7
- Does not require redetermination of eligibility for Medicaid/CHIP more than once a year 5
- Has adopted Medicaid expansion as part of the Affordable Care Act 8
- Has an online dual-benefit form to apply for Medicaid and SNAP 5
- Medicaid pays for maternal depression screening during pediatric/family medicine visits under the child's Medicaid 9
- Has at least one Help Me Grow affiliate site that has fully implemented a centralized access point 10
EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2016]11
- 7 screenings for children <1 year
State requires 5 screens. 100% of eligible screens were completed in 2017.
- 4 screenings for children 1-2 years
State requires 4 screens. 100% of eligible screens were completed in 2017.
- 3 screenings for children 3-5 years
State requires 3 screens. 100% of eligible screens were completed in 2017.
- 4 screenings for children 6-9 years
State requires 2 screens. 100% of eligible screens were completed in 2017.
Early Care and Education
- Sets the income eligibility limit for child care subsidies at or above 200% FPL 12
A family of three qualifies for assistance with a maximum income at $27,816 or 134% FPL. This reflects a decrease from 136% FPL in 2017.
- Uses payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier 12
The reimbursement rate for center care for a four-year-old in St. Louis 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 2017]14
- Funds a pre-kindergarten program and/or supplements Head Start 15
$9,703,786 for pre-kindergarten
- Requires districts to offer full day kindergarten 16
- Requires one adult for every four 18-month-olds in child care centers 17
- Requires one adult for every ten 4-year-olds in child care centers 17
- Requires one teacher for every 12 students in kindergarten classrooms 18
Requires one teacher for every 25 students with a goal of one teacher for every 17 students.
- Has early learning standards or developmental guidelines for infants and toddlers 19
- Has an infant/toddler credential or certificate 20
- Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver 21
- Has implemented a statewide Quality Rating Improvement System (QRIS) 22
Planning for a QRIS.
- Has comprehensive, free-standing standards for social emotional learning at the K-12 level 23
Missouri's Show-Me Standards emphasize gathering and analyzing information, effective communication, problem solving, and responsible decision-making.
- Requires a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers 24
Only lead teachers in public pre-K programs are required to have a minimum of a bachelor's degree.
Parenting and Economic Supports
- Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2017]25
Parent must return to work when child is 3 months old.
- Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2017]25
- Has paid family leave for a minimum of 6 weeks with partial replacement of wages 26
- Offers accrual of at least five paid sick days 27
- Established a state minimum wage that meets or exceeds $10.00/hr and is indexed to inflation for a family of three 28
- Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP 29
Gross income limit is set at 130% FPL. Asset limit is $2,250.
- Exempts single-parent families of three below the federal poverty level from personal income tax 30
- Offers a refundable state Earned Income Tax Credit 31
- Offers a refundable state dependent care tax credit 32
- Offers a refundable Child Tax Credit 33
- Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL 12
Copayments set at 8% of income.
- 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 2017]25
- Offers a minimum of 28 weeks of Unemployment Insurance benefits 34
State provides up to 13 weeks of regular state-funded UI.
Data Notes and Sources
Last Updated: April 17, 2019
Send us recent developments to update your state's profile.
- Chase-Lansdale, P. L., & Brooks-Gunn, J. (2014). Two-generation programs in the twenty-first century. The Future of Children, 24(1), 13-39.
- 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.
- National data were calculated from the 2017 American Community Survey, representing information from 2017. State data were calculated from the 2013-2017 American Community Survey, representing information from the years 2013 to 2017.
- U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2018). The Annual EPSDT Report (Form CMS-416) for FY 2017. https://www.medicaid.gov (accessed January 30, 2019).
- Brooks, T., Miskell, S., Artiga, S., Cornachione, E., & Gates, A. (2018). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2018: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed July 2, 2018).
- Guttmacher Institute. (2019). Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed Feburary 11, 2019).
- 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).
- Kaiser Commission on Medicaid and the Uninsured. (2018). Status of State Action on the Medicaid Expansion Decision. https://www.kff.org (accessed July 13, 2018).
- Smith, S., Granja, M.R., Nguyen, U., Rajani, K. (2018). How States Use Medicaid to Cover Key Infant and Early Childhood Mental Health Services: Results of a 50-State Survey (2018 Update). New York: National Center for Children in Poverty, Mailman School of Public Health, Columbia University.
- Help Me Grow National Center. (2019). Help Me Grow Network Affiliates. https://helpmegrownational.org (accessed January 14, 2019). Email correspondence from Stephanie Luczak on April 4, 2019.
- U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2017). The Annual EPSDT Report (Form CMS-416) for FY 2016. https://www.medicaid.gov (accessed December 11, 2017). Data were not reported for ND.
- Schulman, K. (2018). Overdue for Investment: State Child Care Assistance Policies 2018. National Women's Law Center. https://nwlc.org (accessed November 14, 2018).
- U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. (2018). National Assessment of Educational Progress (NAEP), 2017 Math and Reading Assessment. https://nces.ed.gov(accessed June 29, 2018).
- Tran, V., Minton, S., Haldar, S., & Dwyer, K. (2018). The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2017. OPRE Report 2018-106. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.urban.org(accessed December 3, 2018).
- Friedman-Krauss, A. H., Barnett, W. S., Weisenfeld, G. G., Kasmin, R., DiCrecchio, N., & Horowitz, M. (2018). The State of Preschool 2017: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed November 12, 2018).
- Diffey, L. (2018). 50-State Comparison: State Kindergarten-Through-Third-Grade Policies. Denver, CO: Education Commission of the States. http://ecs.force.com (accessed June 29, 2018).
- Child Care Aware of America. (2018). The Child Care State Licensing Database. Arlington, VA: Child Care Aware. http://licensingdatabase.usa.childcareaware.org (accessed July 25, 2018).
- Diffey, L. (2018). 50-State Comparison: State Kindergarten-Through-Third-Grade Policies. Denver, CO: Education Commission of the States. http://ecs.force.com (accessed June 29, 2018). Data for MS were obtained from MS Kindergarten Guidelines.
- Administration for Children & Families, National Center on Early Childhood Quality Assurance. (2017). State Early Learning and Developmental Guidelines. https://childcareta.acf.hhs.gov (accessed December 19, 2017).
- Administration for Children & Families, National Center on Early Childhood Development, Teaching, and Learning. (2018). State/Territory Infant/Toddler Credential Overview, May 2018. https://childcareta.acf.hhs.gov (accessed December 3, 2018).
- Sosinsky, L., Ruprecht, K., Horm, D., Kriener-Althen, K., Vogel, C., & Halle, T. (2016). Including Relationship-Based Care Practices in Infant-Toddler Care: Implications for Practice and Policy. Brief prepared for the Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
- The Quality Compendium. (2017). Individual State Profiles. https://qualitycompendium.org (accessed January 7, 2019). The most recent data update was from November 2017.
- The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2018). K-12 Learning Goals for SEL in all 50 States. Chicago, IL: CASEL. https://casel.org(accessed June 29, 2018). Data for DC were based on DC Educational Standards.
- Whitebook, M., McLean, C., Austin, L.J.E., & Edwards, B. (2018). Early Childhood Workforce Index 2018. Berkeley, CA: Center for the Study of Child Care Employment, University of California, Berkeley. http://cscce.berkeley.edu (accessed July 25, 2018).
- Heffernan, C., Goehring, B., Hecker, I., Giannarelli, L., & Minton, S. (2018). Welfare Rules Databook: State TANF Policies as of July 2017. OPRE Report 2018-109. 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 January 7, 2019).
- National Conference of State Legislatures. (2018). State Family Medical Leave and Parental Leave Laws. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed July 20, 2018).
- National Partnership for Women & Families. (2018). Paid Sick Days - State and District Statutes. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 20, 2018).
- National Conference of State Legislatures. (2018). State Minimum Wages: 2018 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed July 20, 2018).
- Food and Nutrition Service. (2018). Broad-based Categorical Eligibility. Washington, D.C.: United States Department of Agriculture. https://www.fns.usda.gov (accessed January 14, 2019). Gehr, J. (2018). Eliminating Asset Limits: Creating Savings for Families and State Governments. Center for Law and Social Policy. https://www.clasp.org (accessed January 14, 2019).
- National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2016). 50-State Data, Income Tax Liability. http://nccp.org(accessed July 20, 2018).
- Williams, E., & Waxman, S. (2018). States Can Adopt or Expand Earned Income Tax Credits to Build a Stronger Future Economy. Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed June 29, 2018).
- National Women's Law Center. (2018). State Child and Dependent Care Tax Provisions, Tax Year 2017. Washington, DC: National Women's Law Center. https://nwlc.org (accessed December 3, 2018).
- Tax Credits for Workers and Their Families. (2018). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 20, 2018).
- Center on Budget and Policy Priorities. (2018). Policy Basics: How Many Weeks of Unemployment Compensation Are Available? Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed July 25, 2018).