Alabama Early Childhood State Policy Profile

Overview

The Early Childhood 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 thrive. 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 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

Related Research and Policy Resources

States can support young children’s development by making key policy choices in early health and development. This section of the Profile highlights states’ policy choices for supporting young children’s well-being: 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

Related Research and Policy Resources

States make important decisions about the early care and education services they provide to young children and families. This section of the Profile highlights 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

Related Research and Policy Resources

States make critical policy choices that help low-income parents effectively support young children’s healthy development. This section of the Profile 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.

Young children (under age 6)1: 349,816

Percent of children under 6 by income levels, 2022

Source1

Percent of children under 6 by race/ethnicity, 2022

Source1

Percent of children under 6 by family income and race/ethnicity, 2022

Source1

Percent of children under 6 by parents’ immigration status, 2022*

Source1

*If one of the parents is an immigrant, that case is counted under the immigrant group.

Percent of children under 6 by family income and parents’ immigration status, 2022

Source1

Health and Development Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Sets the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL)

Children <1 year [2024]2
Eligibility is up to 146% for Medicaid and 317% for S-CHIP.

Children 1-5 years [2024]2
Eligibility is up to 146% for Medicaid and 317% for S-CHIP.

Children 6-18 years [2024]2
Eligibility is up to 146% for Medicaid, 146% for M-CHIP, and 317% for S-CHIP. Alabama has a lower bound for adolescents in Title XXI funded Medicaid expansion, being 18% for children aged 14-18.

Pregnant women [2024]3
Eligibility is up to 146% for Medicaid and 317% for From-Conception-to-End-of-Pregnancy (FCEP) CHIP-funded option.

Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2024]4

Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2024]4

Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2021]5

Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2022]6

Provides 12 months of postpartum Medicaid coverage for all eligible women [2024]7
CMS approved Alabama's state plan amendment on January 13, 2023.

Extends Medicaid coverage for family planning to otherwise ineligible low-income women [2023]8
Eligibility based on income up to 146% FPL, which included men. This eligibility ceiling includes a standard "disregard" to an applicant's income equal to five percentage points of the federal poverty level. State also extends Medicaid eligibility for family planning services to people losing full-benefit coverage after the end of the postpartum period. AL operates this program through a waiver that expires on 9/30/2023, and the state has submitted for renewal of this waiver.

Has adopted Medicaid expansion as part of the Affordable Care Act [2023]9

Includes at-risk children in the definition of eligibility for IDEA Part C [2023]10
The relationship between being an at-risk state and the number of children served varies. Some non-at-risk states have higher than average percentages of children being served in Early Intervention (EI). See graphs for the state EI data.

Has an online multi-benefit application form for Medicaid, SNAP, and TANF [2024]11

Requires or recommends maternal depression screening as a part of well-child visits under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit [2023]12
Recommends

Has at least one Help Me Grow affiliate site that has fully implemented a centralized access point [2023]13

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics

7 screenings for children <1 year [FY 2021]14
State requires 5 screens. 65% of eligible screens were completed in 2021.

4 screenings for children 1-2 years [FY 2021]14
State requires 4 screens. 100% of eligible screens were completed in 2021.

3 screenings for children 3-5 years [FY 2021]14
State requires 3 screens. 66% of eligible screens were completed in 2021.

4 screenings for children 6-9 years [FY 2021]14
State requires 4 screens. 46% of eligible screens were completed in 2021.

Percent of children under 6 who lack health insurance, 2022

Source1

Percent of uninsured children under 6 by family income, 2022

Source1

Percent of children under 3 receiving Early Intervention services in 2021-2022*

Source15

*The following state has missing EI data: Maryland.

Percent of children under 3 receiving Early Intervention services by race/ethnicity in 2021-2022*

Source15

*Notes: 1) EI rates are not displayed where the cell size is small as the data are not reliable. 2) The following state has missing EI data: Maryland.

Percent of eligible children who received at least one EPSDT screening, by age, FY 2021

Source16

Early Care and Education Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Sets the income eligibility limit for child care subsidies at or above 85% SMI [2023]17

Uses payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier [2023]17
The reimbursement rate for center care for a four-year-old in Huntsville at the highest quality tier was 10% higher than the rate at the lowest quality tier.

Funds a pre-kindergarten program [2023]18
$173,745,222 from 2022-2023.

Supplements Head Start [2023]18
$5,775,801 from 2022-2023.

Requires districts to offer full day kindergarten [2023]19

Requires one adult for every four 18-month-olds in child care centers [2023]20
Child care regulations require one adult for every 7 children.

Requires one adult for every ten 4-year-olds in child care centers [2023]20
Child care regulations require one adult for every 18 children.

Requires one teacher for every 12 students in kindergarten classrooms [2023]19
Requires one teacher for every 18 students

Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver [2023]20

Has implemented a statewide Quality Rating Improvement System (QRIS) [2024]21

Has comprehensive, free-standing standards for social emotional learning at the K-12 level [2023]22
Has comprehensive, free-standing standards for SEL, Pre-K to age five.

Requires a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers [2020]23
Only lead teachers in public pre-K programs are required to have a minimum of a bachelor's degree.

Monthly child care co-payment fees as a percent of income for a family of three with one child in care, 2023*

Source24

*Note: States with 0% have exempted families from copayments with the exception of OR and MD where families pay very low copayments ($10 & $13, respectively). 

National Assessment of Educational Progress (NAEP) fourth grade math and reading scores, 2022*

Source25

*Note: NAEP defines proficiency as “solid academic performance for the given grade level and competency… including subject-matter knowledge, application of such knowledge to real-world situations, and analytical skills appropriate to the subject matter.”

Parenting and Economic Supports Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2022]26
Recipients caring for a child under 7 months old are exempt.

Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2022]27

Allows TANF participants to receive benefits for a maximum of 60 months in their lifetime without limits on continuous coverage [FY 2022]28

Has paid family leave for a minimum of 6 weeks with partial replacement of wages [2024]29

Offers accrual of at least five paid sick days [2023]30

Established a state minimum wage that meets or exceeds $14.00/hr and is indexed to inflation for a family of three [2024]31
$7.25; minimum wage defaults to Federal Fair Labor Standards Act. No state minimum wage law.

Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP [2022]32
Gross income limit is set at 130% FPL. No asset limit.

Does not charge personal income tax for single-parent families of three below the federal poverty level [TY 2022]33

Offers a refundable state dependent care tax credit [TY 2023]34

Offers a refundable state Earned Income Tax Credit [2024]35

Offers a refundable Child Tax Credit [2024]36

Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2023]17

Offers exemptions and/or extensions of the TANF benefit time limit for recipients who are pregnant [FY 2022]37

Offers exemptions and/or extensions of the TANF benefit time limit for recipients caring for a child under 6 months of age [FY 2022]26

Offers a minimum of 28 weeks of Unemployment Insurance benefits [2024]38
State provides up to 14 weeks of regular state-funded UI.

Funds a housing program that provides rental assistance to low-income families with children at 80% AMI/200% FPL or less to avoid eviction or homelessness [2024]39

Percent of low-income children under 6 by parents’ employment status, 2022

Source1

Education levels of mothers with children under 6, 2022

Source1

Maximum monthly TANF benefit for a family of three, July 2023

Source40

Percent of low-income families with children under 5 that receive SNAP, 2022*

Source1

*Because the available data only allow setting the low-income threshold at 185% FPL, low-income families in this graph include those with annual income below 185% FPL.

Percent of children under 6 living in families that experience housing insecurity, 2022*

Source1

*A child’s family experiences housing insecurity when their rents or owner costs (e.g., mortgage payments) exceed 30% of the family income on a monthly basis.

Data Notes and Sources

  1. State data were calculated from the 2018-2022 American Community Survey, representing information from the years 2018 to 2022. National data were calculated from the 2022 American Community Survey, representing information from 2022.
  2. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 1, 2024, from https://www.kff.org
  3. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 9, 2024, from https://www.kff.org
  4. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved September 19, 2024, from https://www.kff.org
  5. Centers for Medicare and Medicaid Services. (2021). Presumptive eligibility. U.S. Department of Health and Human Services. Retrieved July 14, 2022, from https://www.medicaid.gov
  6. Brooks, T., Gardner, A., Osorio, A., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2022). Medicaid and CHIP eligibility and enrollment policies as of January 2022: Findings from a 50-state survey. Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved February 8, 2023, from https://files.kff.org
  7. Kaiser Family Foundation. (2024). Medicaid postpartum coverage extension tracker. Retrieved October 1, 2024, from https://www.kff.org
  8. Guttmacher Institute. (2023). Medicaid family planning eligibility expansions. Retrieved September 26, 2023, from https://www.guttmacher.org
  9. The Kaiser Family Foundation. (2023). State health facts: Status of state action on the Medicaid expansion decision. Retrieved October 1, 2024, from https://www.kff.org
  10. The Early Childhood Technical Assistance Center. (n.d.). State and jurisdictional eligibility definitions for infants and toddlers with disabilities under IDEA Part C. FPG Child Development Institute, University of North Carolina at Chapel Hill. Retrieved February 15, 2023, from https://ectacenter.org
  11. Brooks, T., Tolbert, J., Gardner, A., Corallo, B., Moreno, S., & Mudumala, A. (2024). A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond. The Georgetown University Center for Children and Families & The Kaiser Family Foundation. Retrieved October 1, 2024, from https://www.kff.org
  12. National Academy for State Health Policy. (2023). Medicaid policies for maternal depression screening (MDS) during well-child visits, by state. Retrieved July 17, 2023, from https://nashp.org NCCP reviewed state policies for AR, FL, KS, NE, and NH as of April 10, 2024.
  13. Help Me Grow National Center. (n.d.). Help me grow network affiliates. Retrieved June 21, 2024, from https://helpmegrownational.org Email correspondence from Melissa Miller on June 10, 2024.
  14. Centers for Medicare and Medicaid Services. (2023). The annual EPSDT report: Form CMS-416 for fy 2021. U.S. Department of Health and Human Services. Retrieved May 23, 2023, from https://www.medicaid.gov
  15. Early Intervention (EI) rates were calculated by using data from three sources: 2021-2022 EI cumulative counts collected by the US Department of Education, 2018-2022 American Community Survey data, and the 2021-2022 American Community Survey data. EI rates are not displayed where cell size for the numerator (number of children in EI) is missing, or cell size for the denominator (total number of children) is less than 200. To access EI data, please go to IDEA Section 618 Data Products: Table 11 Cumulative count of infants and toddlers birth through age 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state 2021-2022. https://data.ed.gov . To access ACS data, please visit the US Census Bureau data tool. https://data.census.gov
  16. Centers for Medicare and Medicaid Services. (2023). The annual EPSDT report: Form CMS-416 for fy 2021. U.S. Department of Health and Human Services. Retrieved June 7, 2023, from https://www.medicaid.gov
  17. Schulman, K. (2024). Two steps forward, one step back: State child care assistance policies 2023. National Women's Law Center. Retrieved June 12, 2024, from https://nwlc.org
  18. Friedman-Krauss, A. H., Barnett, W. S., Hodges, K. S., Garver, K. A., Jost, T. M., Weisenfeld, G. G., & Duer, J. K. (2024). The state of preschool 2023: State preschool yearbook. National Institute for Early Education Research. Retrieved June 22, 2024, from https://nieer.org
  19. Education Commission of the States. (n.d.). State education policy tracking. Retrieved August 24, 2023, from https://www.ecs.org NCCP also referenced: Fischer, A., Jamieson, C., Silva-Padron, G., Peisach, L., & Weyer, M. (2023). ECS's 2023 50-state comparison: State kindergarten-through-third-grade policies. Education Commission of the States. Retrieved August 24, 2023, from https://www.ecs.org
  20. Child Care Technical Assistance Network. (n.d.). National database of child care licensing regulations. Office of Child Care, Administration for Children & Families, U.S. Department of Health & Human Services. Retrieved August 23, 2023, from https://licensingregulations.acf.hhs.gov
  21. The Quality Compendium. (2024). State profiles. The BUILD Initiative. Retrieved March 13, 2024, from https://qualitycompendium.org
  22. Collaborative for Academic, Social, and Emotional Learning (CASEL). (n.d.). Social-emotional learning policy at the state level. Retrieved July 31, 2023, from https://casel.org
  23. McLean, C., Austin, L. J. E., Whitebook, M., & Olson, K.L. (2021). Early childhood workforce index: 2020. Berkeley, CA: Center for the Study of Child Care Employment, University of California, Berkeley. Retrieved March 10, 2021, from https://cscce.berkeley.edu
  24. Schulman, K. (2024). Two steps forward, one step back: State child care assistance policies 2023. National Women's Law Center. https://nwlc.org
  25. National Center for Education Statistics. (2022). National Assessment of Educational Progress (NAEP), 2022 math and reading assessment. Institute of Education Sciences, U.S. Department of Education. Retrieved January 24, 2023, from https://nces.ed.gov
  26. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov
  27. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov NCCP reviewed state policies for OR and WI as of March 27, 2024.
  28. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov NCCP reviewed state policies for AR, CT, IN, NM, and NY as of April 10, 2024.
  29. National Partnership for Women & Families. (2024). State paid family and medical leave insurance laws. Retrieved October 1, 2024, from https://www.nationalpartnership.org
  30. National Partnership for Women & Families. (2023). Paid sick days - State and district statutes. Retrieved April 5, 2024, from https://nationalpartnership.org
  31. National Conference of State Legislatures. (2024). State minimum wages. Retrieved September 27, 2024, from http://www.ncsl.org
  32. Aussenberg, R.A., & Falk, G. (2023). The Supplemental Nutrition Assistance Program (SNAP): A primer on eligibility and benefits (CRS Publication No. R42505). Congressional Research Service. Retrieved August 28, 2023, from https://crsreports.congress.gov
  33. NCCP's calculations derived from output generated by the National Bureau of Economic Research Internet TAXSIM Version 35, available at https://taxsim.nber.org for the 2022 tax year. For a description of the TAXSIM model, see Feenberg, D. and Coutts, E. (1993). An Introduction to the TAXSIM Model. Journal of Policy Analysis and Management 12(1): 189-194.
  34. National Women's Law Center. (2024). States can make care less taxing, tax credits related to child care, tax year 2023. Retrieved April 5, 2024, from https://nwlc.org
  35. Tax Policy Center. (2024). State EITC as Percentage of Federal EITC. Urban Institute & Brookings Institution. Retrieved October 1, 2024, from https://www.taxpolicycenter.org For CA, CO, CT, HI, ME, MO, MT, NM, UT, VA, & WA, NCCP also referenced: Tax Credits for Workers and Families (2024). State Tax Credits. Retrieved October 1, 2024, from https://www.taxcreditsforworkersandfamilies.org
  36. National Conference of State Legislatures. (2024). Child tax credit overview. Retrieved October 1, 2024, from https://www.ncsl.org
  37. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2024). Welfare rules databook: State TANF policies as of July 2022 (OPRE Report 2023-327). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved April 5, 2024, from https://www.acf.hhs.gov NCCP reviewed state policies for SC as of March 27, 2024.
  38. Center on Budget and Policy Priorities. (2024). Policy basics: How many weeks of unemployment compensation are available? Retrieved September 16, 2024, from https://www.cbpp.org
  39. National Low Income Housing Coalition. (n.d.). Rental housing programs database. Retrieved April 16, 2024, from https://nlihc.org
  40. Azevedo-McCaffrey, D. & Aguas, T. (2024). Continued increases in TANF benefit levels are critical to helping families meet their needs and thrive. Center on Budget and Policy Priorities. Retrieved July 4, 2024, from https://www.cbpp.org

Last updated on October 17, 2024