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More than half of Missourians don't have access to affordable licensed child care.

That means more parents have to cut down work hours, add time to their commute or resort to unregulated in-home facilities to provide child care for their children.

According to a 2018 study from the Center for American Progress, a research group dedicated to progressive policies, 54 percent of Missourians live in child care deserts, areas with an insufficient supply of child care providers.

This definition takes into account the number of young children in the area, the number of providers and the number of children per slot in a licensed child care facility or home.

The existence of child care deserts often means that parents have to choose between caring for their children or working.

"Instead of allowing it to be a family decision, by not having access to quality child care in their area, the decision is made for them," said Craig Stevenson, director of policy and advocacy at Kids Win Missouri, a children's advocacy organization. "So, it may not be what's in the best interest of the families. That may not be what they want, but that's what they're forced to do because of the situation they're in."

Sosha Chaney knows this firsthand. She's had to switch providers multiple times for her two oldest children because of the lack of affordable child care in Missouri.

Cost is one of the primary reasons that access is an issue in Missouri. In the northern Kansas City suburbs, where Chaney and her family live, child care can cost almost $16,000 annually, the Columbia Missourian reported.

Many of these facilities cost the same amount she pays for housing. Before she found her current child care provider, if she wanted to put her children in a facility near her home, she was forced to choose between making rent payments or paying for child care.

"Do I want to have a house to live at, or do I want to have child care?" she said.

Chaney qualifies for the Child Care Subsidy Program, through which the state assists eligible Missouri parents and guardians with payments for child care. While this subsidy program helps because she won't have to pay as much out of pocket, Chaney is still limited as to which facilities her children can attend.

This is because many licensed facilities don't accept government subsidies as a form of payment. So Chaney is not only tasked with finding a facility that suits her children, but also with finding one that accepts subsidies.

Even if a facility does accept subsidies, it typically doesn't cover the full cost. Until six years ago, Chaney still had to pay a sliding fee, or the portion of child care expenses that a family has to pay directly to child care providers based on income.

Although the subsidy helped, Chaney still struggled to make the fee payments. She would switch child care facilities on almost a monthly basis because of the frequent sliding fee changes.

She's since found a solution through Operation Breakthrough, a nonprofit child care center in Kansas City that accepts subsidies and doesn't require sliding fees. Parents whose children attend Operation Breakthrough don't pay anything out of pocket — it's covered by subsidies, federal funding and donations.

Because of this program, child care is no longer a financial burden for Chaney and her family. However, many families in Missouri don't have access to programs like Operation Breakthrough. For families with incomes below the poverty line, paying for child care — even if it is just a sliding fee — is often out of the question.

The problem is just as nuanced for families who neither fall below the poverty line nor make enough money to afford licensed facilities.

Robin Phillips, the CEO of Child Care Aware Missouri, a nonprofit organization that works to raise the quality of child care and provide resources for parents, said families that don't qualify for subsidies need to consider more factors. These factors center on whether facilities offer discounts or scholarships depending on the number of children or other income factors.

Even in cases where cost and subsidies aren't issues, access is still limited.

"Despite all the factors that we suggest people look at, there's just not enough availability, especially when you get into the rural areas," Phillips said.

Lack of available child care is a problem Casey Hanson, a Columbia resident, knows well. Although she and her husband can afford to place their 18-month-old son in a licensed facility, none of the facilities in Columbia had spots available.

"It was surprising to me that if you have the money and you are able to make it work, it still doesn't mean that the slots are going to be available," Hanson said.

Hanson said she would spend hours looking online and often wouldn't get a concrete answer on whether a facility had the space for her son.

"Anxiety-inducing is certainly the word that I'd attribute to the process," she said.

This pattern is especially prevalent in rural communities. In Missouri, 2.2 million people — 37 percent of Missouri's total population — live in areas considered rural, according to the Missouri Department of Health and Senior Services.

For families living in rural areas, access to affordable child care is far more limited. The Center for American Progress' study shows rural families face higher challenges in accessing child care compared to families living in urban or suburban areas. National averages show three in every five families in rural areas will have trouble accessing licensed facilities.

"In general, we see clusters of licensed child care in cities," said Katie Hamm, early childhood vice president at the Center for American Progress. Although patterns vary by state, the rural-urban divide holds true nationally. Within cities, child care is often concentrated in higher-income areas and may not be accessible to lower-income residents because of transportation constraints and cost, she added.

National averages from the Center for American Progress' study also show it's not just Missourians having trouble accessing child care. About 51 percent of Americans live in what is considered a child care desert.

For families who live in areas without affordable licensed child care, unlicensed in-home facilities are often the only viable solution.

These facilities are typically not registered with the state, which means they are not regulated like licensed facilities are.

The lack of regulation can cause problems for some facilities. Children in unlicensed in-home facilities are at a greater safety risk, which is part of the reason why sending children to licensed facilities is important, Hamm said.

"When you go to a restaurant, people assume that the health department has been there to inspect it, and child care needs to be the same way," Hamm said. "It's all the more important that a child care center has that basic inspection to make sure that the children are safe. It's kind of a fundamental role of the state to make sure that parents can go to work and know that their children aren't in danger."

There is a bill working its way through the Missouri Legislature that looks to fix some of these concerns. It won't make Missouri any less of a child care desert, but it will make unlicensed facilities safer.

Sponsored by Sen. Jill Schupp, D-Creve Coeur, Senate Bill 336, or Nathan's Law, was inspired by the death of Nathan Blecha. He was 3 months old when he suffocated in an unlicensed in-home child care facility. His mother later learned the facility's operator was watching more children than recommended. Schupp's legislation aims to prevent what happened to Blecha from happening to other families.

The legislation would improve care through two proposed methods: setting a safe number of children allowed in a single facility and creating accountability for employees.

The maximum number of children allowed in an in-home facility is currently four, but that number doesn't take into account the unlimited number of children related to the facility's operator. The legislation would change that, so that all children under school age, related or not, count in the new allowed total of six.

The bill will increase the penalties for violators. Currently, violators receive a $200 fine and an infraction. This bill will move it up to a $750 fine and a class C misdemeanor.

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