North Carolina in bottom five for state services to children 3-and-under



(The Center Square) – National analysis for resources available for children 3 years old and under has placed North Carolina among the worst five states in the nation.

The data gathering happened after lawmakers agreed to Medicaid expansion but before its enactment. This means that next year, the ranking is likely to be better as was the case for South Dakota this year.

The Prenatal-to-3 Policy Impact Center at Vanderbilt University ranked all 50 states and the District of Columbia. The ranking does not reflect individual hospitals and their performance; rather, its equation “combines a state’s minimum wage, paid family leave, out-of-pocket child care expenses, nutrition benefits, and federal and state income taxes and credits to illustrate how the minimum level of resources available to a stylized family varies across states.”

North Carolina is No. 47, ahead of Wyoming, Tennessee, Pennsylvania and Georgia.

The dollar figure the report says is available to working North Carolinian parents is $27,761. Georgia’s $20,560 was the worst and D.C.’s $47,051 the best.

A dozen areas of state investment were ranked.

The report recognized North Carolina’s intent to expand Medicaid. When analyzed, only parents earning up to 37% of the FPL are eligible for Medicaid coverage.

There is no statewide paid family leave program; state minimum wage defaults to the federal $7.25 an hour; and there is no refundable state earned income tax credit.

The analysis says North Carolina has met the criteria for key policies of simplified income reporting to reduce administrative burdens with the Supplemental Nutrition Assistance Program; and has Medicaid funding and state funding for comprehensive screening and connection programs.

“A state’s policy choices do not operate in isolation from one another,” the policy paper said. “Instead, they interact to create a system of support of varying generosity for parents and children. Tax credits and near-cash supports, such as SNAP, provide valuable resources to families. However, state minimum wage, paid family leave, and child subsidy policies are significant drivers of the variation across states in the number of resources a working parent has available to support their family.”

There was poor scoring – having not met criteria of key policies – in child care subsidies; group prenatal care; community-based doulas; evidence-based home visiting programs; early Head Start; and early intervention services.

“Comprehensive reviews of the most rigorous evidence available identified four state-level policies and eight strategies that positively impact at least one of these PN-3 policy goals,” the paper said. “The 12 effective solutions are profiled in this Prenatal-to-3 State Policy Roadmap. When combined, the policies and strategies create a system of care that provides broad-based economic and family supports, as well as targeted interventions to address identified needs.”



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