Research-based policies, practices and programs

Create state-level refundable tax credits for working families to raise incomes and help pay for child care and other expenses.

Refundable state tax credits increase incomes for working middle-class and poor families. They also help families manage the high costs of child care and allow parents to choose the care that best fits their families’ needs.¹

A tax credit is an amount of money that is subtracted from the taxes someone owes. Refundable means that if the amount of the tax credit is more than the amount of taxes owed, the difference is given as a tax refund.²

Refundable tax credits have positive, lasting effects on parents’ longer-term earnings and health outcomes. Children whose parents benefit from refundable tax credits:

• Improve their school performance
• Have higher rates of college enrollment
• Work more hours as adults
• Earn higher incomes than their peers whose parents did not benefit from the tax credit

Results from a small pilot study in New York City revealed demonstrable improvements in young children’s development when mothers received a monthly cash payment of $100 versus $20.³ In 2017, a research team of developmental psychologists, neuroscientists and economists launched a four-city study (New York City, St. Paul, Omaha and New Orleans) of the impact of small, regular cash payments on children’s development and parental functioning.⁴ Results of the study are not yet available.

Tax credit refunds also improve community economic stability, as the cash returned is spent in communities.⁵

Free, high quality tax preparation services, like the IRS-supported Volunteer Income Tax Assistance (VITA) program:

• Help working families take advantage of refundable tax credits
• Maximize eligible refunds and credits
• Keep filing error rates low⁶

Two refundable tax credit options include the Earned Income Tax Credit and the Child and Dependent Care Tax Credit.

Earned Income Tax Credit

The federal Earned Income Tax Credit (EITC) is a benefit for working people who have low to moderate income. It reduces the amount of taxes owed and, if the amount of the benefit is greater than the taxes owed, it provides a tax refund.⁷

In 2015, 931,000 North Carolina families (around 25 percent) claimed the federal EITC, receiving an average payment of $2,462 and adding $2.3 billion to the North Carolina economy.⁸

Twenty-six states and the District of Columbia also have state EITC programs, where the state also provides a refundable credit, usually pegged to a percentage of the federal credit. In 23 of those states, the EITC is fully refundable.⁹ North Carolina had a refundable state EITC in place from 2007 to 2014, when it was eliminated.¹⁰

Child and Dependent Care Tax Credit

The federal Child and Dependent Care Tax Credit (CDCTC) is a credit for the costs of child care or care for another family member. It supports parents’ ability to work or look for work. Parents can submit annual care expenses of up to $3,000 for one child or $6,000 for two or more children, and they will receive a credit for 20 to 35 percent of those expenses, depending on their income.¹¹ 

Twenty-two states and the District of Columbia also have state CDCTC programs. In half of those states, the credit is refundable.¹² North Carolina’s Child and Dependent Care Tax Credit was eliminated in 2013.¹³

Increase the percentage of working parents with access to paid family and medical leave and the opportunity to take leave.

Supporting parents to have time to bond with their infants in the weeks after birth is important for children’s socio-emotional development and attachment. Paid leave policies are associated with:

• Strengthened family stability
• Lower rates of maternal depression
• Greater job retention¹

Businesses that create family-friendly workplaces have found that they have a competitive advantage in attracting and retaining talent, increasing productivity and employee satisfaction and reducing absenteeism. In fact, companies spend more time, money, and resources to train a new employee than they spend to allow an employee to take leave and return to his or her position.²

Currently, nearly one in four women nationwide goes back to work within two weeks of delivering her baby.³ Businesses are increasingly offering paid leave, however. In 2016, 17 major U.S. corporations, including Amazon, eBay, Facebook, Hilton and others, announced new paid paternity and adoptive parent leave ranging from two weeks to six months, a significant increase from the leave these companies offered in 2015.⁴

The federal Family and Medical Leave Act (FMLA) requires that employers with 50 or more employees provide up to 12 weeks of unpaid family and medical leave to eligible employees.⁵

To date, four states have enacted state paid family leave laws—California, New Jersey, Rhode Island, and New York. The State of Washington passed a paid parental leave statute 10 years ago, but it has not yet been funded.⁶

Paid leave under FMLA is not required by NC law—employers included in FMLA may decide to provide paid or unpaid leave. Family leave can be taken upon the birth of a child or the placement of a child through adoption or foster care. FMLA may also be taken to care for a family member who has a serious health condition, or for an employee’s own health circumstances.⁷

Ensure needed leave for expectant mothers and parents.

Under North Carolina law, there are a few additional benefits in place for pregnant women and parents that could be improved or expanded.

• North Carolina Equal Employment Practices Act. North Carolina has not enacted a state law that specifically requires employers to offer pregnancy leave. But employers with a workforce of 15 or more must provide pregnant employees with leave benefits the same as those provided to other employees with temporary disabilities. This may include paid leave, unpaid leave or no leave at all.¹
• North Carolina Domestic Violence Leave. North Carolina employers may not discipline, fire, demote, or refuse to promote employees who take reasonable time off work to obtain (or attempt to obtain) an order of protection from domestic violence for the employee or a minor child.²
• North Carolina Small Necessities Law. All employers must give employees up to four hours of unpaid leave per year to attend or otherwise be involved in a child’s school.³

Maintain the current high rate of insured children and increase health insurance coverage rates for parents.

Children with health insurance are more likely than uninsured children to have:

• Regular preventive health care and other needed services
• A medical home
• Fewer emergency room visits
• Their health care needs met¹

When parents have health insurance, they are more likely to access needed health services for their children.²

Most children in North Carolina have health insurance. In 2015, 96 percent of children in the state were insured, with more than 40 percent of children insured through Medicaid and Health Choice.

North Carolina parents are less likely to be insured than their children. In 2015, 20 percent of North Carolina children lived with a parent who was not covered by any health insurance.³ In addition, nearly a quarter of insured adults do not have enough coverage or cannot make use of the insurance due to high co-pays and deductibles.⁴

North Carolina’s public child and family health insurance coverage currently includes:

• Coverage for children living in households with incomes up to 211 percent of the Federal Poverty Level (FPL), through Medicaid or Health Choice (North Carolina’s Children’s Health Insurance Program, or CHIP)
• Maternity coverage for pregnant women with household incomes up to 196 percent of FPL
• Coverage for parents with dependent children with a household income of up to 45 percent of FPL
• Coverage for family planning (the Be Smart program) for those with incomes up to 195 percent of FPL⁵

Include ACEs screening and trauma-informed care across governmental agencies at the state and county levels.

The Adverse Childhood Experiences (ACEs) screen measures 10 types of childhood trauma, including:

• Physical, verbal and sexual abuse
• Physical and emotional neglect
• Substance abuse and domestic violence in the home
• Family member in jail or with a mental illness
• Absence of a parent through divorce, death or abandonment¹

ACEs have long-term effects on children’s health, education and career outcomes.² Screening for ACEs can help providers understand what children and families are dealing with.

A trauma-informed program, organization, or system:

• Recognizes the impact of trauma, including ACEs, on children, families and the staff who serve them
• Recognizes potential paths to recovery
• Integrates knowledge about trauma into agency policies, practice, and programs
• Seeks to avoid re-traumatization³

In a trauma-informed environment, policy, practice, and interventions change from a top-down, hierarchical approach of “servicing” clients to authentic person- and family-centered case practice, intervention, and community support.⁴ Around the country, this approach is now being implemented across human services, including within the workforce development field,⁵ education,⁶ and child welfare.⁷

A legislative or administrative policy that supports trauma-informed care could encourage North Carolina agencies at the state, county and community levels to integrate ACEs screening and trauma-informed care into existing polices, practice, and interventions. Duke University provides technical assistance to the National Center for Child Traumatic Stress and could help with strategic framing for this kind of policy.⁸

Creating trauma-informed systems will require the expansion of professional development on the use of trauma-informed case practice across sectors and counties. An example is the North Carolina Child Treatment Program (NC CTP), which trains mental health clinicians in evidenced-based, trauma-informed treatment models and keeps a public roster of all trained clinicians. The program thereby increases children’s access to trauma-informed care in a variety of public and private settings. NC CTP also tracks data and outcomes to aid the mental health community in progress monitoring.⁹

Ensure that state policy work now underway to address the North Carolina opioid epidemic includes a focus on:

• Multi-generational family impact
• Babies born addicted to opioids
• Implications for the child welfare system
• Pregnancy prevention

Opioid addiction is a serious and growing problem in North Carolina.

• A 2016 report of the 25 most opioid-addicted cities in the U.S. included four North Carolina communities: Wilmington (#1), Hickory (#5), Jacksonville (#12), and Fayetteville (#18).¹
• A 2017 Asheville Citizen Times article reported that more than 16 million pain reliever pills were prescribed in Buncombe County in 2015—more than 64 pills per person.²
• Mission Hospital in Asheville treated nearly 3,000 people for opioid-related problems in 2016, almost double the number of opioid-involved patients in 2012. Nearly 400 babies delivered at Mission Hospital tested positive for drugs and had to be treated for withdrawal at birth.³

In 2016, the U.S. Congress passed a $1.1 billion two-year funding package to address the opioid epidemic nationally.⁴ North Carolina’s Department of Health and Human Services has put in place an Opioid Action Plan for 2017-2021. It includes the following strategies:

• Coordinating the state’s infrastructure to tackle the opioid crisis
• Reducing the oversupply of prescription opioids
• Reducing the diversion of prescription drugs and the flow of illicit drugs
• Increasing community awareness and prevention
• Making naloxone widely available
• Expanding treatment and recovery systems of care
• Measuring the effectiveness of these strategies based on results⁵

To address the impact on young children, the plan could consider multi-generational family impact, neonatal addiction, child welfare implications and service needs, and pregnancy prevention.

Modernize work and child care reporting requirements, worker supports, and child care provider capacity based on low-income parents’ needs.

Low-income working families face several challenges as they try to find safe, quality child care that works with their schedules.¹

• Low-wage workers may work second and third shifts and weekends, and work schedules may change often and without much notice.
• Reliable, high quality child care is often unavailable outside of traditional working hours.
• Shifting work schedules can mean an unpredictable cash flow, making consistent child care payments a challenge. Child care centers cannot sustain themselves without regular clients and regular, predictable use and payments.
• The pressure is rising for increasing quality in child care settings, which means the cost of child care rises as well.

The federal Child Care and Development Fund (CCDF), which provides funding for child care subsidies to working families, requires reporting and verification of job hours and schedules. This can be difficult, given the challenges listed above. Research has shown that this reporting and verification requirement contributes to child care churn as well as processing delays that cause working parents to lose child care slots.

The federal child care subsidy program does not require that work hours and authorized child care hours match precisely, however. It also encourages states to support payment levels and timing necessary for providers to remain in business. Several states have made adjustments to their state-level requirements to make it easier on parents and keep children in child care more consistently.

• Colorado state law was amended in 2014 to prohibit linking child care hours to parents’ work, training, or education schedules.²
• Rhode Island adopted a policy of parental self-report of work hours and schedules and has seen dramatic improvements in the time needed to process child care subsidies.³

Analyze the assignment and collection of child support payments in North Carolina to determine the benefits and challenges for children, custodial parents, and non-custodial parents.

In federal fiscal year 2015, $32 billion in child support payments was collected from non-custodial parents (parents without legal custody of their children) by state and tribal child support enforcement programs. Three-quarters of the child support paid was collected by withholding income from employees’ paychecks. Nationwide, 16 million children benefitted from child support enforcement that year, and three out of ten of those children lived in families with incomes below the federal poverty level. For these families, child support enforcement accounted for 41 percent of family income.¹

The National Center for Children in Poverty reports that one in three noncustodial parents is poor as well. Many face similar workforce barriers that custodial parents face. When states enact policies to strictly enforce child support collection, the orders may be too high for low-income noncustodial parents to pay. This can result in additional legal action being taken against the noncustodial parent and the accumulation of high levels of child support debt before they can pay any support.²

In 2014, almost $815 million dollars in court-ordered child support was due to North Carolina custodial parents, and more than $280 million of this was not paid.³

The cost of housing in North Carolina contributes to homelessness and housing instability.

• Someone working for minimum wage ($7.25 per hour) would have to work 70 hours a week to rent a one-bedroom apartment at the fair market rate (a federal standard set at the 40th percentile of a local or state housing market).
• Families would have to earn $15.32 per hour to afford a two-bedroom apartment.¹

Families dealing with obstacles like poverty and mental illness may also need supports and services to successfully stay in housing. Local housing authorities have traditionally played a strong role in linking residents to these community-based services. Funding reductions in recent years have limited housing authorities’ capacity to provide support services, however, which may tip more families into homelessness.²

The North Carolina Coalition to End Homelessness does a statewide, unduplicated count of homeless people on a single night during the last week of January each year. Individuals living in emergency and domestic violence shelters, transitional housing, on the street, in abandoned buildings, in their cars or “other places not meant for habitation” are counted through this data collection process.³

• Statewide, 0.12 percent of people are homeless
• There is great variability across the state—the highest percentages occur in western counties, while the largest numbers of homeless individuals are in counties with large urban centers, including Mecklenburg, Wake, Guilford, and Durham
• One in five homeless individuals is a child (22 percent)
• Thirteen percent are parents⁴

Drive responsible economic development and job growth, matched to sector-specific opportunities, that provides parents with wages to adequately support their families.

North Carolina expects most of its employment growth over the current decade (2012 through 2022) to be in industries that provide services. Of the estimated nearly 550,000 new positions, nine of ten are expected to be in service industries. Many of those industries—like food service, accommodation, real estate, and educational services—do not pay, on average, enough for one earner to support a family.¹

Sectoral workforce development links economic development and workforce preparation in sectors where growth can reasonably be expected. This approach focuses on the needs of employers within a specific industry and in a specific geography.² A core element of sectoral workforce development is creation of sector-specific intermediaries that align training resources with employment opportunities. A sector intermediary is often a consortium of stakeholders from government, business, non-profit, education, and training organizations. Job seekers are placed in industry-recognized training programs that are expected to result in high quality jobs—often apprenticeships, where they gain specific credentials. Sectoral intermediaries may perform other functions as well, including analysis of training needs of both businesses and workers, pursuing private and public funding, and evaluating training programs.³

One example of a sector-specific effort in North Carolina is the Work Keys credential programs in automotive manufacturing, welding, and biotechnology. Through this program, workers develop industry-specific skills that can lead to higher wages and continued educational advancement. To date, however, for every 10,000 workers in North Carolina, just 20 have some type of industry-specific certificate or credential.⁴

Authorize and support partnerships with higher education research institutions to study and advise on barriers and opportunities for families to build local social supports and social capital.

Informal supports and community social capital have been shown to help parents function more successfully in the face of continued toxic stressors such as poverty, trauma, and violence.¹  Informal supports and social capital are core elements of a Protective Factors framework² as well as effective two-generation strategies.³

North Carolina can provide needed services as a bundle, simplify the application process for family support programs, and ensure that every eligible family is enrolled.

A bundle of work supports that provides modest improvements across many aspects of a family’s life is most effective. An effective bundle of supports aims to:¹

• Improve parents’ education levels
• Improve parental health and mental health
• Raise family incomes

To streamline the application process and ensure more eligible families are enrolled, NC could:

• Implement a “no wrong door” policy, so that any community or state agency provider can determine a family’s eligibility for services and supports
• Allow families to complete one application to receive access to all benefits they are eligible for,² e.g., Medicaid, the Children’s Health Insurance Program (NC Health Choice), SNAP (food assistance), and other types of federal assistance.  
• Review internal and interagency rules and application procedures to simplify and streamline application processes

Integrating services and supports can:

• Improve cost-efficiency
• Improve family economic outcomes
• Reduce stress on low-income families

High levels of parent stress can increase the risk of child maltreatment, including harsh discipline practices and low levels of parent warmth and nurturing behavior.³ Parent stress is linked to the challenges of living in poverty without the benefits of supportive services, including housing and mental health treatment.⁴

The North Carolina Work Support Strategies Initiative aims to streamline policies, service delivery, and program eligibility to create a “no wrong door” system.⁵ As part of the initiative, North Carolina continues to expand implementation of its NC FAST integrated eligibility system. NC Families Accessing Services through Technology (NC FAST) was developed as a tool to improve the way eligibility is determined and benefits given for services, including:

• Food and Nutrition Services, North Carolina’s SNAP program
• Medicaid, and NC Health Choice, North Carolina’s CHIP program
• TANF and Work First
• Subsidized Child Care/Child Care Financial Assistance
• Refugee Assistance

Building on the NC FAST initiative, North Carolina can continue to improve state, county, and organizational capacity for real-time data reporting and use across agencies serving the same clients.

The North Carolina Early Childhood Integrated Data System¹ (ECIDS) collects and integrates data from Subsidized Child Care, NC Pre-K, Early Intervention, IDEA Part C, Vital Records, Child Protective Services, SNAP (food assistance), Work First (TANF), Preschool IDEA Part B, and Head Start/Early Head Start to report on overall child outcomes. The national Early Childhood Data Collaborative offers a guide on the top ten fundamentals of a comprehensive, integrated data system.²

Strengthening Families™ is a research-informed approach to increase family strengths, enhance child development, and reduce the likelihood of child abuse and neglect. It engages families and the community to build on five research-informed protective factors:  

• Parental resilience
• Social connections
• Knowledge of parenting and child development
• Concrete support in times of need
• Social and emotional competence of children¹

More than 30 states, including North Carolina, are working to embed the Strengthening Families approach across child- and family-serving systems, from early childhood education to child welfare.²

The North Carolina Department of Social Services is partnering with the Center for the Study of Social Policy to implement the Protective Factors Framework in child welfare policy and practice. Parents and other state and local agencies are part of the process.³ The five goals of this effort are to:

• Integrate the protective factors framework into child maltreatment prevention funding sources
• Develop a set of outcomes and indicators that measure the impact of the child welfare system’s work
• Increase the capacity of those who provide child maltreatment prevention services in the state to embed the protective factors approach into their service provision work
• Coordinate the prevention work of the multiple child- and family-serving systems in the state
• Integrate the protective factors approach into state and local child welfare practice

Circle of Parents is an example of a preventive service in North Carolina that is anchored in the protective factors framework. It is a process where parents provide support and help to each other. Evaluation results have found that the program results in significant increases in parent resilience, social-emotional support, concrete support, and parental nurturing and attachment.⁴ Prevent Child Abuse North Carolina (PCANC)⁵ provides the infrastructure support necessary for quality implementation of the program, including access to coaching, technical assistance, training, and evaluation assistance.

Expand access to such federally-funded or federally-reimbursed supports as WIC (nutrition assistance for pregnant mothers and young children), SNAP (food assistance), child care subsidies, workforce supports and Medicaid coverage for income-eligible families with young children in North Carolina. (Link to Programs page where we list all programs from all the briefs, in ABC order, with their short descriptions)

Eligible North Carolina families are under-enrolled or under-served in many of these federal programs. Participation in these programs helps ensure that low-income families’ and children’s basic needs are met, thereby improving outcomes¹ such as:

• Short- and long-term child and family health
• Education
• Economic outcomes

Family outreach to increase enrollment could include use of social media, public education venues, interagency “warm handoffs,” and increased legal supports for low-income families.