State Policy as an Influence on the Participation of Young Children with Medical Needs in Childcare

Abstract

The authors collected data from 48 states and the District of Columbia regarding state policies that affect the participation of children with medical needs in licensed childcare. They began with a more narrowly focused agenda of identifying policies affecting children with medically complex needs, but because few regulations are directed to this population, broadened their inquiry. The authors propose a conceptual change in the way professionals think about children with medical complexity. They argue that individual children may enter (and leave) a “zone of medical complexity” rather than being part of a fixed population they term children with medical complexity. Additional findings are clustered into six thematic areas: restrictions on dispensing of medications, policies on other medical treatments, higher subsidies and other financial supports, childcare health consultants and other informational resources, policies regarding specialized centers, and issues related to boards of nursing or nurse practice acts. Within each thematic area, the authors identify specific states that have recently enacted important policy changes.