August 12, 2020

When schools and child care facilities temporarily closed in March, local governments, charities, and health care organizations combined efforts to ensure essential workers had child care. Many states offered a variety of options from child care subsidies to designated child care facilities for essential workers.

3 imperatives for investing in successful community partnerships

Many child care facilities and schools have since re-opened. As a result, several states allowed their public subsidies and programs to lapse. Yet as Covid-19 cases continue to surge in many parts of the country—and school districts opt for virtual-only schooling—essential employees are again caught between caring for their children and going to work, but with less governmental support than before.

This challenge is particularly acute for health care employees for two reasons: First, women account for more than three-quarters of the workforce. Working mothers have been forced to take on a disproportionate share of child care responsibilities during the epidemic, leaving many to consider switching to a part-time job or leaving the workforce altogether.

Second, health care also has a greater proportion of workers in single-parent households than all other major industries, and may have less support in their familial networks to lean on for child care. Roles with the highest share of single parents included nursing and home health care staff, who are critical to responding to Covid-19 surges.

3 conversations leaders should have now with public officials

It's clear that as national Covid-19 cases continue to climb, health care employees will need additional child care support to work. Likely, health care employers and local governments will need to collaborate to provide this coverage.

Health care leaders should reach out now to local public officials to plan for long-term child care support. This includes organizations in markets with a low number of Covid-19 cases, which can use their respite now to create a contingency plan for a future upswing. Start with the three following conversations:

  • If schools are virtual-only, what child care options will be available for essential workers?

  • As many school districts opt for virtual-only learning, employees with school-age children who are too young to care for themselves find themselves in an impossible situation. Organizations in markets with virtual-only learning should collaborate with the local government to ensure employees have child care for school-age children—for example, they could work with the local school district to keep a few classrooms and afterschool programs open for the children of essential workers. Even those areas with an in-person schooling option now should develop a contingency plan if school districts are forced to close in the future.

  • What are the infection control guidelines in place for child care facilities and schools?

    Even if child care facilities and schools are open now, those without stringent infection control can cause an outbreak—leading to both a market-level Covid-19 surge, and leaving employees without child care options. For example, relaxed infection control policies for child care facilities in Texas led to a June outbreak of nearly 600 Covid-19 cases. Hospital leaders can help by developing or reviewing these policies in collaboration with local officials.

  • Under what circumstances will emergency child care programs resume, if they've lapsed?

    Amid new calls to "reset" the U.S.' Covid-19 response, it's worth exploring with public officials what programs would be available for essential employees if child care facilities and schools were closed. Consider asking for employee feedback on previous programs or subsidies to better tailor support in subsequent closures.

Starter list of health care-led initiatives for employee child care

Apart from how they are partnering with the local government to ensure child care coverage, health care organizations should take a critical eye to their internal supports for working parents. Doing so could not only stabilize the workforce, decreasing absenteeism and keeping parents in the workforce long-term, but also differentiate the organization as an employer at a time when parental benefits are more important than ever.

As a starting point, see the below list of ways health care organizations can better support working parents right now.

  • Expand existing on-site child care. Organizations already offering on-site child care are the best equipped to respond to child care disruptions in their market. Consider expanding existing services to add additional age groups, hours, and enrollment capacity.

  • Offer drop-in child care for emergencies. Many parents are relying on fragile networks of family, friends, and babysitters for child care. If any one person is unavailable, employees may have to call out of work at the last minute. Creating an on-site drop-in child care service can give working parents a safety net during the current uncertainty, without committing to long-term enrollment. Another option for emergency child care is to partner with a vendor, such as Bright Horizons, to match employees with day care or in-home offerings.

  • Offer structured, virtual socialization and/or counseling to children. As school closures stretch on indefinitely, parents are responsible for not only child care coverage, but also the overall socialization and development of their children. This is even more important for the children of health care workers, who may have additional anxiety about their family's safety. Health systems could help parents support their children by offering virtual, age-based, small group cohorts of group therapy. If the system has employees such as pediatric social workers or educators on furlough, consider asking them to step in. Another option is to contract with outside child development experts, or to subsidize access to vendors offering opportunities for socialization, such as Outschool.

  • Offer workers access to virtual parenting classes or teacher coaching sessions. Even if they aren't working from home, most working parents are acting as part-time homeschooling teachers to help their children absorb virtual lessons. Employers could contract with teaching and development experts to help parents address challenges such as creating a routine, or managing behavior issues that are cropping up as a result of social distancing. Even if systems can't subsidize the full cost, curate a short list of coaches or host private-label workshops or webinars from parent coaching groups like the Parent Encouragement Program.

  • Offer flexible hours or telework options. If possible, consider offering a greater variety of shift start times and lengths to give working parents more flexibility over their schedule. For outpatient practices, this flexibility could even lend itself to overcoming another obstacle: expanding patient access, as working parents opt for evening shifts and appointments.

What is your organization doing to support working parents?

As employee child care continues to be a major health care challenge, we want to share examples of how organizations are supporting working parents. Reach out to me directly at RewersL@advisory.com to share your ideas, stories, and successes.

3 imperatives for investing in successful community partnerships

Population Health Advisor researchers partnered with JPMorgan Chase & Co.’s corporate responsibility and philanthropy teams to understand how progressive provider organizations across the country have long been investing in community health transformation.

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