Healthy Births and the Early Years

Florida’s Healthy Start program provides home visitation to pregnant women, women between pregnancies, and infants up to three years of age to improve pregnancy outcomes and early child development. These services are especially critical for families in or near poverty, who face significant risks during pregnancy and often lack access to necessities to support early childhood development.

In a report commissioned by the Florida Legislature, researchers found that the majority of Healthy Start enrollees were also enrolled in Medicaid through 2020, but 73% of eligible enrollees actually received services through Healthy Start due mainly to funding shortfalls. Medicaid Managed Care programs and the Healthy Start programs have very little overlap in the types of services provided and the lack of families accessing both of these services means that the loss of Medicaid could have a negative impact on those not enrolled in both. Unfortunately, Florida resumed Medicaid disenrollments in early 2023 which places mothers and infants at risk of losing access to critical health services.

Quality child care begins with ensuring that well-educated, trained and appropriately paid staff care for and educate young children using an enriching curriculum in an equally stimulating environment. Lack of child care funding leads to low salaries for child care workers s and workloads high enough to quickly cause burn-out, driving experienced and accredited staff away from working in child care. In 2022, only 32% of Florida’s center-based child care programs and 8% of family child care homes were nationally accredited, yet the average cost of child care was $9,750 per year which is equal to 35% of medium-income to a single parent family. 

Florida only subsidizes 52% of eligible children through the Child Care Development Block Grant (CCDBG). In 2022, Florida received an additional $19 million in CCDBG funding, but this increase failed to keep up with inflation. Investments in child care that expand access to affordable, quality child care act as a tool to combat inflation by creating career opportunities, expanding the workforce, and increasing productivity.

Florida’s Voluntary Pre-Kindergarten Program (VPK) for four-year-olds tends to focus more on quantity and access rather than proven research-based quality. Although Florida’s VPK is one of the largest in the country, its value is undermined by low quality standards documented over the program’s nearly 20-year existence.  Major issues include the on-going refusal to require college-degreed lead teachers, too high class size caps, a 3-hour per day rather than full day offering and insufficient pre-service training for other classroom staff.  The gap in access to pre-k quality by high income families and those more in the middle or lower brackets is the start of the achievement gap bemoaned by policy-makers as children progress through grade, middle and high school.

Institutional support options for children with disabilities, such as those within schools, are critical for helping children and families overcome barriers to the best quality of life possible. Florida has made significant albeit recent progress by adjusting policies within schools that were detrimental to students with disabilities, including the removal of seclusion as a behavior modification and outlining in statute the only acceptable options for physical restraint and the steps to be taken prior to that action. These are important advances but more needs to be done.

Black youth with disabilities are less likely than their White peers to receive a variety of special education services including receiving a 504 plan or Individualized Education Plans (IEPs). Without access to appropriate support, Black students are seven times more likely to be arrested for disorderly conduct than their White peers.

Additional support beyond traditional institutional settings is the next step towards maximizing the welfare of children with disabilities and their families. One of the most important and effective types of non-institutional care is community-based programs. The most successful models emphasize the responsibility of children and families to self-advocate and self-support, placing families in a position of agency over their own path. By empowering parents and children to find the support they need, families are able to receive much-needed assistance while transitioning into stability and sustainability. Florida should focus its additional efforts towards helping parents easily identify and access the resources their children need.