North Carolina Early Childhood Profile

Overview

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.

Young children (under age 6)3: 709,333

Source 3

Source 3

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* 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.

Health and Development

Sets the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) [2020]4

  • Children <1 year
  • Children 1-5 years
  • Children 6-18 years
  • Pregnant women
  • Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2020]4
  • Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2020]4
  • Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2020]4
  • Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2020]4
  • Extends Medicaid coverage for family planning to otherwise ineligible low-income women [2020]5
    Eligibility based on income up to 200% FPL, includes men and individuals younger than 19 years of age.
  • Includes at-risk children in the definition of eligibility for IDEA Part C [2020]6
  • Does not require redetermination of eligibility for Medicaid/CHIP more than once a year [2020]4
  • Has adopted Medicaid expansion as part of the Affordable Care Act [2020]7
  • Has an online dual-benefit form to apply for Medicaid and SNAP [2020]4
  • Medicaid pays for maternal depression screening during pediatric/family medicine visits under the child's Medicaid [2018]8
  • Has at least one Help Me Grow affiliate site that has fully implemented a centralized access point [2019]9
    Help Me Grow North Carolina is working toward fully implementing a centralized access point.

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2018]10

  • 7 screenings for children <1 year
    State requires 5 screens. 100% of eligible screens were completed in 2018.
  • 4 screenings for children 1-2 years
    State requires 4 screens. 100% of eligible screens were completed in 2018.
  • 3 screenings for children 3-5 years
    State requires 3 screens. 79% of eligible screens were completed in 2018.
  • 4 screenings for children 6-9 years
    State requires 4 screens. 51% of eligible screens were completed in 2018.

50-State Data    Information on EC Policies

Source 3

Source 10

Early Care and Education

  • Sets the income eligibility limit for child care subsidies at or above 200% FPL [2019]11
    A family of three qualifies for assistance with a maximum income at $40,836 or 191% FPL. This reflects a decrease from 197% FPL in 2018.
  • Uses payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier [2019]11
    The reimbursement rate for center care for a four-year-old in Mecklenburg county at the highest quality tier was 117% higher than the rate at the lowest quality tier.
  • Provides families with at least 12 months of continuous eligibility for child care subsidies [FY 2018]12
  • Funds a pre-kindergarten program [2019]13
    $154,072,222 in 2018
  • Supplements Head Start [2019]13
  • Requires districts to offer full day kindergarten [2018]14
  • Requires one adult for every four 18-month-olds in child care centers [2020]15
    Child care regulations require one adult for every 6 children.
  • Requires one adult for every ten 4-year-olds in child care centers [2020]15
    Child care regulations require one adult for every 20 children.
  • Requires one teacher for every 12 students in kindergarten classrooms [2020]15
    Child care regulations require one teacher for every 25 students.
  • Has early learning standards or developmental guidelines for infants and toddlers [2019]16
  • Has an infant/toddler credential or certificate [2018]17
  • Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver [2020]15
  • Has implemented a statewide Quality Rating Improvement System (QRIS) [2020]18
  • Has comprehensive, free-standing standards for social emotional learning at the K-12 level [2020]19
  • Requires a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers [2018]20
    Only lead teachers in public pre-K programs are required to have a minimum of a bachelor's degree.

50-State Data    Information on EC Policies

Source 10

Source 21

Parenting and Economic Supports

  • Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2018]22
    Exemption limited to 12 cumulative months in the recipient's lifetime.
  • Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2018]22
  • Has paid family leave for a minimum of 6 weeks with partial replacement of wages [2019]23
  • Offers accrual of at least five paid sick days [2020]24
  • Established a state minimum wage that meets or exceeds $11.50/hr and is indexed to inflation for a family of three [2020]25
    $7.25
  • Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP [2019]26
  • Does not charge personal income tax for single-parent families of three below the federal poverty level [2018]27
  • Offers a refundable state Earned Income Tax Credit [2020]28
  • Offers a refundable state dependent care tax credit [2018]29
  • Offers a refundable Child Tax Credit [2020]30
    North Carolina's non-refundable Credit for Children was repealed and converted to a new child tax deduction for the tax year 2018.
  • Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2019]11
    Copayments set at 10% 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 2018]22
    Single parents caring for a child under 12 months old are exempt from the benefit waiting period time limit.
  • Offers a minimum of 28 weeks of Unemployment Insurance benefits [2020]31
    State provides up to 12 weeks of regular state-funded UI; 9.6 weeks of extended benefits are also available through the end of 2020 in response to the COVID-19 pandemic.
  • Funds a housing program that provides rental assistance to low-income families with children to avoid eviction or homelessness [2020]32

50-State Data    Information on EC Policies

Source 3

Source 3

Source 19

Data Notes and Sources

  1. Chase-Lansdale, P. L., & Brooks-Gunn, J. (2014). Two-generation programs in the twenty-first century. The Future of Children, 24(1), 13-39.
  2. 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.
  3. National data were calculated from the 2018 American Community Survey, representing information from 2018. State data were calculated from the 2014-2018 American Community Survey, representing information from the years 2014 to 2018
  4. Brooks, T., Roygardner, L., Artiga, S., Pham, O., & Dolan, R. (2020). Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: 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 7, 2020).
  5. Guttmacher Institute. (2020). Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed January 22, 2020).
  6. NCCP collected this data point as part of a 50-state survey on supports for infant-toddler mental health in state Part C programs as of February 21, 2020.
  7. Kaiser Commission on Medicaid and the Uninsured. (2020). Status of State Action on the Medicaid Expansion Decision. https://www.kff.org (accessed July 1, 2020).
  8. 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; National Academy for State Health Policy. (2018). Medicaid Policies for Maternal Depression Screening (MDS) during Well-Child Visits, by State. https://healthychild.nashp.org (accessed January 22, 2020).
  9. Help Me Grow National Center. (2019). Help Me Grow Network Affiliates. https://helpmegrownational.org Email correspondences from Stephanie Luczak on April 4, 2019 and May 17, 2019.
  10. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2018). The Annual EPSDT Report (Form CMS-416) for FY 2018. https://www.medicaid.gov (accessed November 21, 2019).
  11. Schulman, K. (2019). Early Progress: State Child Care Assistance Policies 2019. National Women's Law Center. https://nwlc.org (accessed November 12, 2019). Texas data were updated based on email correspondence with Shay Everitt at the Texas Workforce Commission on September 10, 2020; see the Workforce Development Letter regarding child care provider maximum reimbursement rate increases.
  12. Tran, V., Dwyer, K., & Minton, S. (2019). Key Cross-State Variations in CCDF Policies as of October 1, 2018: The CCDF Policies Database Book of Tables. OPRE Report 2019-117. 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 January 30, 2020).
  13. Friedman-Krauss, A. H., Barnett, W. S., Garver, K. A., Hodges, K. S., Weisenfeld, G. G., & DiCrecchio, N. (2019). The State of Preschool 2018: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed October 31, 2019).
  14. 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).
  15. NCCP's review of state child care licensing regulations as of August 17, 2020. Policies were retrieved from the National Database of Child Care Licensing Regulations. https://childcareta.acf.hhs.gov
  16. Administration for Children & Families, National Center on Early Childhood Quality Assurance. (2019). Early Learning and Developmental Guidelines. https://childcareta.acf.hhs.gov (accessed August 1, 2019). Texas data were updated based on email correspondence with Shay Everitt at the Texas Workforce Commission on September 10, 2020; see the Texas Infant, Toddler, and Three-Year-Old Early Learning Guidelines and Training.
  17. 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).
  18. The Quality Compendium. (2020). Individual State Profiles. https://qualitycompendium.org (accessed July 6, 2020).
  19. The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2020). State Scan Scorecard Project. Chicago, IL: CASEL. https://casel.org (accessed July 15, 2020).
  20. 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).
  21. U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. (2019). National Assessment of Educational Progress (NAEP), 2019 Math and Reading Assessment. https://nces.ed.gov June 30, 2020).
  22. Goehring, B., Heffernan, C., Minton, S., & Giannarelli, L. (2019). Welfare Rules Databook: State TANF Policies as of July 2018. OPRE Report 2019-83. 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 October 22, 2019).
  23. National Partnership for Women & Families. (2019). State Paid Family and Medical Leave Insurance Laws. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 15, 2019).
  24. National Partnership for Women & Families. (2020). Paid Sick Days - State and District Statutes. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 15, 2020).
  25. National Conference of State Legislatures. (2020). State Minimum Wages: 2020 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed January 30, 2020).
  26. Food and Nutrition Service. (2019). Broad-based Categorical Eligibility. Washington, DC: U.S. Department of Agriculture. https://www.fns.usda.gov (accessed Feburary 6, 2020). NCCP also reviewed state policies for AK, AR, KS, LA, MS, MO, SD, TN, UT, VA, and WY.
  27. National Center for Children in Poverty (NCCP). (2018). 50-State Data, Income Tax Liability. Obtained internally through email correspondence with Seth Hartig dated on July 21, 2020.
  28. Williams, E., Waxman, S., & Legendre, J. (2020). 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 July 15, 2020).
  29. National Women's Law Center. (2019). Making Care Less Taxing: State Child and Dependent Care Tax Provisions, Tax Year 2018. Washington, DC: National Women's Law Center. https://nwlc.org (accessed October 24, 2019).
  30. Tax Credits for Workers and Their Families. (2020). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 15, 2020).
  31. Center on Budget and Policy Priorities. (2020). Policy Basics: How Many Weeks of Unemployment Compensation Are Available? Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed July 15, 2020).
  32. NCCP's review of state-funded rental housing programs as of August 17, 2020. Programs were retrieved from the National Low Income Housing Coalition Database. https://reports.nlihc.org Recent funding information was obtained through email correspondence with state contacts for DC, IL, MA, and NJ.