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‘We could start to move the needle’: Iowa offers model for fixing Mass. child-care crisis

Iowa Methodist nurse manager Megan Carter picked up her youngest son, Oliver, from his last day at the child-care center in August. The hospital parent company, UnityPoint Health, recently received $2 million in grant funding to build a similar facility at Allen Memorial Hospital in Waterloo.Scott Morgan for The Boston Globe

BROOKLYN, Iowa — Cassie Foels still remembers the helpless panic that came over her six years ago when the small day-care center that looked after her 10-month-old daughter suddenly and unexpectedly closed.

A single mother, she had nowhere to turn. Waitlists at the few other centers in this tiny, rural town could be months long. She didn’t even have vacation time to stay home for a day. Her daughter’s father worked 12-hour construction shifts and couldn’t help. Foels badly needed the money she made working at a local veterinary clinic. But if she stayed on the job who would take care of Coralynn?


It was, she said, a nightmare, one that eventually forced her to leave her job and threatened to unravel her life — and one that might seem familiar to some parents in Massachusetts, where an acute child-care crisis is in full bloom. Indeed, child-care shortages are threatening families across the country. One million women are missing from the labor force compared to pre-pandemic levels, according to the US Chamber of Commerce. A third of them cite child care as a barrier to returning to work.

Activity assistant Cassie Foels, pregnant with her second child, worked at the Brooklyn Community Estate in Brooklyn, Iowa, in August. The nursing home is building its own child-care center just around the corner.Scott Morgan for The Boston Globe

Iowa’s child-care crisis at the time of Foels’ trouble was every bit as bad as Massachusetts’. But something remarkable happened in the intervening years that is now grabbing national attention. The state launched an innovative policy initiative for a massive expansion of child care that in two years created nearly 11,000 more spots for the children of working parents.

That push, championed by the state’s Republican governor and backed by its GOP-controlled Legislature, has transformed Foels’ experience as a single mother. Her second daughter arrived in late August, but Foels found a day-care spot without much effort because the nursing home where she now works is building its own child-care center just around the corner, at which employees will pay deeply discounted rates.


All of that is being made possible by Iowa’s initiative, an incentive program that offers grants to private businesses willing to build their own child-care centers or purchase seats at existing facilities.

While some aspects of the industry have rebounded, securing child care still remains profoundly difficult in Massachusetts. Thousands of children statewide are still on wait lists to get a slot at a center-based or family child-care program. And prices have pushed into the stratosphere. Parents in Middlesex and Norfolk counties pay more than $26,000 annually for child care, according to the Department of Labor — a price that outstrips annual in-state tuition at any University of Massachusetts campus. Only parents in Virginia’s Arlington County and California’s San Francisco County pay more.

As Governor Maura Healey vows to boost the state’s competitiveness, policymakers and business leaders in Massachusetts say they recognize that astronomical costs rank high among the reasons young families struggle in Massachusetts, forcing some to leave. But while political leaders and child-care advocates have talked of taking bold action, to date no plan on the scale of Iowa’s has gelled.

“We are at a point in time where looking at what other states are doing is really important in getting to where we want the Commonwealth to be,” said Tom Weber, a former early education commissioner under Deval Patrick and Charlie Baker who leads a coalition of employers that see child care as a matter of economic competitiveness and are interested in using child care as a tool for attracting and retaining talent. “It’s not a novel idea … but it hasn’t happened as a matter of broad public policy.”


Weber and other experts in Massachusetts see Iowa as a possible model.

Just as in Massachusetts, Iowa’s child-care industry was plunged into crisis after plummeting enrollment and mass closures during the pandemic.

Even before the pandemic hit in 2020, there was not enough child care to go around in Iowa. Then, as the country isolated in their homes, came widespread closures of child-care centers. When the pandemic subsided and workers began returning to offices, demand for child care spiked. It created a child-care disaster.

As of 2021, the most recent data available, nearly a quarter of all Iowans lived in a “child care desert,” defined by the left-leaning think tank Center for American Progress as an area where there are either no child-care providers at all or so few that there are three times more children in need of care than there are child-care spots. According to state data, that percentage is even higher for parents with infants and toddlers.

Child care is also expensive for Iowa families. For the average Iowa family of four, the monthly cost of child care far outpaces the cost of housing, state figures show.

The hefty economic consequences of parents forced to miss work, or even quit — including roughly $935 million in lost annual tax revenue, according to an estimate by Governor Kim Reynolds — prompted the governor in fall 2020 to convene a task force of business leaders, child-care providers, and local elected officials to come up with solutions.


The group’s work led to the new state incentive program, which matched whatever a business was willing to spend funding new slots for their employees at local child-care centers or building on-site child-care facilities.

Businesses of all kinds and sizes — hospitals, transportation companies, furniture factories, nursing homes — rushed to apply. Iowa has so far given out $75 million in such grants, resulting in nearly 11,000 new child-care slots, according to state officials, with a third round of grants on the way. The program is widely considered one of the most successful in the country.

The program was not without growing pains. Finding and recruiting staff to meet state-mandated classroom ratios was a struggle, particularly given the low salaries that are commonplace in the industry. “You can go to a Casey’s convenience store and make more than a lot of what the child-care centers are paying,” said Cathy Essick, marketing director at Brooklyn Community Estate in Brooklyn, Iowa, the nursing home where Foels works.

Yet the grant program is broadly considered a success, and the nursing home is one of the beneficiaries. With a $426,000 grant from the state, it plans to open a new nearby child-care center early next year that will eventually serve 90 children.

Such a facility was a long-held dream of the nursing home’s owner, Shane Sissell, who said the home never before had enough money to make it a reality.


“There is stress. We see it with the employees when they have to call in. They are losing money and wages. Plus, we pay more when staff absences force the nursing home to bring in backup help,” Essick said. “There are so many benefits to this.”

Cassie Foels, activity assistant, and her daughter Coralynn, 6, on Aug. 17, at the Brooklyn Community Estate in Brooklyn, Iowa.Scott Morgan for The Boston Globe

The home’s new center plans to enroll children of nursing home employees as well as employees of a neighboring highway construction company that helped the nursing home achieve the 75-employee minimum required to be eligible for a state grant. Nursing home employees will pay half the standard tuition.

It will open at 5:30 a.m. to accommodate early-morning shift workers — hours that no other child-care facility in the area provides.

A flood of new child care has eased parental stress across the state. In tiny West Bend, employees at the Country Maid baked goods factory now enjoy half-off tuition at a local child-care center. In downtown Des Moines, scrub-clad Iowa Methodist Medical Hospital employees drop off their kids at a facility across the street, expanded with help from a state grant. And in Dubuque, several area employers including John Deere used a grant to convert a former call center into a center for 120 children set to open early next year.

Megan Carter picked up her son Oliver, 5, from day care at the Child Development Center in Des Moines, Iowa. Scott Morgan for The Boston Globe

Iowa is not the first state to offer incentives in hopes of jump-starting child care. But incentives in states including Kansas, New Mexico, and South Carolina have typically come in the form of tax incentives, not grants, which have proven less successful. The federal government also offers a tax credit for employers who invest in child care for their employees but it is relatively small and participation is low.

Iowa, on the other hand, has gotten traction by offering money up front and requiring employers to put some of their own cash toward fixing the problem. Iowa’s governor from the start also framed the child-care problem as an economic imperative and the grants as a critical tool for employers to recruit and retain the workers they need to thrive.

“Let’s remove the obstacles to high-quality, affordable child care so that Iowa families can nurture their kids while parents maintain the maximum freedom to enter and remain in the workforce,” Reynolds said in her 2021 speech announcing the grant program. Her call received a standing ovation from lawmakers and guests in attendance.

Another key to Iowa’s success, according to those involved in Iowa’s program and some of its admirers in Massachusetts, is a partnership it forged with the Iowa Women’s Foundation, a nonprofit organization. The governor tapped the group to essentially act as the grant program’s agent, taking responsibility for both selling the program to employers around the state and then helping those businesses navigate the process of obtaining and putting the grant money to work.

In taking on that role, the foundation made the grant program’s success its sole mission and accepted tasks the government was not as well-equipped to handle. Foundation president Deann Cook said the reason it agreed to take on such a big job is that reliable child care is the key to overcoming all of the myriad barriers women in particular face trying to achieve economic success.

“If you don’t have child care, you can’t begin to address them,” Cook said. “You can’t go to school, you can’t have a job. You can’t do training.”

In Massachusetts, the Healey-Driscoll administration and state lawmakers have passed two rounds of funding in recent years aimed at shoring up the state’s child-care sector as COVID-era federal funds that kept many providers afloat dry up. Without those state funds, providers here say they’d be facing a total crisis; the Department of Early Education and Child Care estimates that without these so-called C3 grants as many as 18,000 child-care slots would disappear.

But many advocates say it is time for bigger action. Dawn DiStefano, who heads a nonprofit child-care operation in Springfield, Square One, said legislators should address the child-care crisis on the scale that Iowa has done.

“We could start to move the needle,” DiStefano said. “I think they are capable of doing this.”

There appears to be at least some movement in that direction. A legislative commission formed in 2020 to take on the post-pandemic child-care crisis made it a “short-term goal” to engage the business community and explore incentives for employers, taking inspiration from states like Iowa.

Business leaders from the Massachusetts Business Roundtable and the Business Coalition for Early Childhood Education worked with Assistant Majority Leader Representative Alice Peisch, an influential player on Beacon Hill, to craft a bill.

The bill, modeled by business leaders after Iowa’s public-private partnerships, aims to help businesses offer child care to their employees or expand existing child-care benefits. The state would match half of the costs of buying child-care slots, retrofitting buildings to support child care, or building an on-site facility, and would create a commission to look into a possible state employer tax credit to further encourage businesses to offer child-care benefits to employees, as well as the feasibility of requiring businesses to provide child care as a benefit for their employees.

“It’s basically another item on the menu for employers to support their employees’ child-care needs,” JD Chesloff of the roundtable said.

Back in Brooklyn, Iowa, this past August, Foels paused from setting up a fitness class for nursing home residents and looked out the window, her hand resting on her pregnant belly.

Through the glass and over the wrought-iron fence, festooned with flags, she saw the elementary school her daughter Coralynn will attend and next to it, a shady patch of grass where the new child-care center building will sit.

Six years ago, Foels was worried about her options for her daughter and her own stability.

But this year, she said, everything is different.

Samantha J. Gross can be reached at samantha.gross@globe.com. Follow her @samanthajgross.