Fedcap Community Impact Policy Institute Advances Health-Centered Approach to Child Care Expansion

New York, NY — The Fedcap Community Impact Policy Institute today released Protecting Health in Child Care Expansion, laying out a comprehensive policy roadmap to ensure that New York’s historic investments in child care deliver not only expanded access, but a system that is stable, safe, and built to last.

Authored by Jay K. Varma, M.D., the report builds directly on the Institute’s earlier work, It Takes a Village: Opening Doors to Child Care Through Seamless Integration with the Education System, which advanced a structural vision for expanding access through integration with schools and public systems. That report emphasized co-location, workforce pathways, and alignment across the P-20 education continuum as essential strategies to increase capacity and improve outcomes.

Protecting Health in Child Care Expansion extends that framework by arguing that integration alone is insufficient without embedding health readiness into the core design of the system. Together, the two reports outline a comprehensive strategy: one focused on scaling access through integration, and the other ensuring that expansion is resilient, sustainable, and capable of withstanding the public health, workforce, and environmental challenges that have historically destabilized the sector.

“As New York continues to expand child care, we have to recognize that health is not a secondary consideration—it is what determines whether the system actually works day to day,” said Christine McMahon, President and CEO of Fedcap. “If programs are closing due to illness, if staff cannot stay healthy enough to work, or if facilities are not equipped to keep children safe, then access alone will fall short. Building health readiness into child care from the outset is what will ensure this expansion is reliable, sustainable, and truly delivers for families.”

The report establishes a three-part framework for health readiness that defines whether child care programs can remain open, staffed, and trusted over time. The first dimension, child health readiness, focuses on ensuring that every child entering care is screened for developmental and health needs, and supported with clear pathways to early intervention and care. The second, workforce health readiness, recognizes that the system’s stability depends on the health and well-being of educators and staff, many of whom lack access to adequate health coverage and professional supports, contributing to high turnover and chronic understaffing. The third, built environment health readiness, addresses the physical conditions of child care facilities, including ventilation, environmental safety, and preparedness for climate-related disruptions, all of which directly affect whether programs can remain open and safe for children.

The report concludes that weaknesses in any one of these areas can undermine the entire child care system, creating a cycle of instability that affects families, employers, and the broader economy.

To address these challenges, the Institute outlines a coordinated policy agenda that integrates health into governance, funding, workforce policy, and infrastructure. The report calls for the creation of a permanent Early Childhood Health Readiness Task Force to align agencies and embed health standards into regulation and funding decisions. It recommends investing in health and safety infrastructure such as ventilation, lead remediation, and sanitation systems. It advances new approaches to stabilizing the workforce, including expanding access to health care to reduce illness-related disruptions.

The report also emphasizes the importance of strengthening training requirements so that child care professionals are equipped to manage infection control, chronic health conditions, and trauma-informed care. It highlights the opportunity to better integrate child care with Medicaid and public health systems, allowing services such as developmental screening follow-up and care coordination to occur directly within child care settings. In addition, it calls for modernizing oversight through unified inspection and data systems, accelerating the co-location of child care in public facilities such as schools, and strengthening emergency preparedness and indoor air quality standards to address climate and public health risks.

A full copy of the report can be found here.