When North Dakota lawmakers reconvene next month, they'll have a host of recommendations for improving child care to consider, including a new policy framework offered by a statewide group.
The North Dakota Child Care Action Alliance said it compiled its suggestions after hosting six listening sessions earlier this year. The group is calling for the creation of a workforce fund to provide supplemental wages and support for continuing education and training.
Zach Packineau, director of outreach and programming for the North Dakota Voices Network and a member of the alliance, said setting aside dollars to help provide competitive pay will go a long way in helping care centers deal with recruitment and retention issues.
"We need to change the perception of the work that child care workers and providers do," Packineau asserted. "They're not just glorified babysitters; these are teachers, these are educators who are helping the state's children to achieve very important milestones."
Federal data show the median wage for child care workers in North Dakota is around $11 an hour, just barely above the poverty level for a family of three.
In September, Gov. Doug Burgum announced a working plan to address the state's child care crisis, including expanding the eligibility pool for the Child Care Assistance Program, and adding a state child care tax credit.
Alliance members have said the governor's plan is a step in the right direction, but also hope the state adopts a robust final plan with wages serving as a key component.
Packineau emphasized lawmakers need to keep an open mind as parents still struggle to find affordable care.
"Because this crisis is so huge, we really need some long-term, innovative solutions," Packineau contended.
The coalition said North Dakota needs about 10,000 more child care slots to meet the demand for young children with working parents. To staff these additional slots, the state needs at least 1,400 more child care workers.
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As Congress continues to threaten deep cuts to the Medicaid program, a new KFF report shows how some of the proposed changes could end coverage for an estimated 20 million people nationwide, more than 800,000 in Illinois. One idea targets the Medicaid expansion federal match rate. The federal government currently pays 90% of the costs for people covered under what's known as the Medicaid expansion, that extended coverage to nearly all low-income adults.
Liz Williams, senior policy analyst with KFF, explained that if the federal match rate drops, Illinois would have two options: come up with more than $40 billion to cover expansion costs or drop it altogether.
"Illinois has a law where the state is required to automatically end expansion coverage if the match rate drops, so in those trigger law states, there's 12 of them, enrollees are at greater risk of losing coverage," she explained.
Nearly 30% of Medicaid enrollees in Illinois have health-care coverage because of the Medicaid expansion and would be at risk of losing it should these changes go through.
The Medicaid expansion under the Affordable Care Act was enacted to reduce the number of uninsured people nationwide. It provided states with an increased federal match rate to help pay for their health-care costs. Williams added that if states can't afford to pick up the added costs from decreased federal support, the number of uninsured people will dramatically increase, and any gains in financial security and health outcomes associated with the expansion would be reversed.
"Medicaid is jointly funded by states and the federal government, so any restrictions in federal Medicaid spending really leaves states with tough choices about how to offset reductions," she continued.
She said states have a few options, including increasing state tax revenues, decreasing spending on non-Medicaid services such as education, or decreasing coverage for other groups. Governor J.B. Pritzker has already proposed eliminating Medicaid coverage for non-citizen adults aged 42 to 65 as a way to make up for the state's $1.7 billion-budget gap.
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Local governments across Georgia are facing a critical decision on a homestead exemption that would change how property taxes increase. Augusta commissioners just held their final public hearing on the issue. House Bill 581 would cap annual property tax hikes based on inflation, preventing steep increases - but taxes reset when a home is sold or significantly modified.
Dan Funsch, Augusta-Richmond County resident, urged commissioners not to opt out of the measure, calling on them to uphold the will of voters.
"On Nov. 5, 62% of Richmond County voters already decided this. I don't think it is a good idea for our elected officials to nullify, to just overlook that," he said.
Local governments have until March 1st to opt out of the law. Lawmakers are considering extending the deadline further with House Bill 92, sponsored by Rep. Shaw Blackmon, R-Houston County. The bill, which passed the Georgia House in a 173-1 vote, would push the opt-out deadline to March 31st. It now moves to the Senate for consideration.
While the exemption could bring stability for homeowners, Sue Parr spoke representing the Metro Chamber of Commerce. She believes it may shift costs to renters and businesses, and argues that with only half of Augusta's residents owning homes, many people would see no benefit.
"But with only 50.9% of people having a home, we leave over 100,000 people of Augustans without any tax benefit at all. And in fact, those will be the same people that might incur increased costs," Parr explained.
Mayor Garnett Johnson said that while the decision is easy for cities with booming residential growth, Augusta's situation is more complicated. With only half the population owning homes, he says officials must carefully consider how the exemption would affect small businesses and the local economy.
"The concern is how do we make sure that we protect the commercial businesses to commercial property owners to small businesses in a way that doesn't send them to neighboring counties," he said.
Some speakers at the hearing suggested Augusta could design its own tax relief program rather than adopting the state exemption. Commissioners are expected to hold a special meeting next week to determine their next steps. Meanwhile, the Richmond County Board of Education has already opted out, voting 9-1 against the exemption due to financial concerns.
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Worker's rights advocates and nursing home providers say Washington has a long-term care workforce crisis, and that inadequate benefits in the nursing home industry are part of the problem.
Legislation moving through Olympia - known as the Essential Worker Healthcare Program - would provide affordable health insurance to nursing home workers.
Alicia Harris is a certified nursing assistant, or CNA, at a skilled nursing facility. She said a family of four has to pay $1,200 a month for insurance, with a high deductible and a 30% co-pay.
"It's money that we could be putting towards, you know, groceries," said Harris. "We could be putting towards rent, savings. It's tough."
Nursing home employers who join the new program would receive a payment from the state to provide at least platinum level health plans, which would be matched by Medicaid.
Employees could participate for about $50 a month.
Supporters of the legislation say poor nursing home benefits fuel an extremely high CNA turnover rate. Harris said when there isn't enough staff, the residents don't get the care they deserve.
"I love my residents," said Harris. "I love doing what I do, and I would hate to leave them just because of health insurance. But at the same time, it is a financial burden on me and my family."
Over the next ten years, the number of people who need long-term care in Washington, especially nursing home care, is expected to grow rapidly.
At the current rate, there won't be enough skilled care-givers to meet the need. Two Essential Workers Healthcare Program bills are currently in committee in Olympia.
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