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With staff shortages plaguing child care and mental health facilities, NC lawmakers asked for funding

Forsyth County mom Daphne Alsiyao, right, and her eight-month-old daughter Ella Rose, joined lawmakers and business leaders Thursday for a news conference promoting legislation to address the child care shortage.
Colin Campbell
Forsyth County mom Daphne Alsiyao, right, and her eight-month-old daughter Ella Rose, joined lawmakers and business leaders at a 2023 news conference promoting legislation to address the child care shortage.

State health officials told a legislative oversight committee Tuesday that more funding will be needed to fix critical staffing and financial shortfalls facing North Carolina's childcare and mental health facilities.

North Carolina had a net loss of more than 50 child care facilities in the second half of last year, and state officials worry more could shut down this year after federal funding expires.

State lawmakers got an update Tuesday on the crisis facing child care providers. Federal stabilization funding that helped facilities stay afloat during the COVID-19 pandemic will end this June. A recent survey of providers by the N.C. Child Care Resource and Referral Council found that nearly a third could be forced to close if they can't find other sources of funding after June. The majority have staff shortages and are looking at raising tuition.

"If applied to the total number of child care programs in North Carolina, (the closures) would represent 1,535 out of the 5,400 programs currently operating in North Carolina," the survey report said.

Ariel Ford with the state Department of Health and Human Services said the legislature should look at increasing state subsidies to help.

"What we know is that the child care subsidy as we have it now is based on what our local families can afford to pay, but that's not really what it costs," Ford said. "What that means is that those wages just keep getting pushed down for child care, because they can't raise the cost anymore for families to afford it."

The median wage for child care workers is just $14 an hour, far less than what workers earn at retailers like Target and Costco. "It's hard to compete with that," Ford said, adding that the problem is exacerbated in rural areas because the subsidy rates there are sometimes even smaller.

Mental healthcare also facing shortages

More than a third of state-run psychiatric hospital beds are empty thanks to a shortage of staff. State lawmakers are being asked to look again at pay increases to recruit more healthcare workers.

About 30% of the positions in state psychiatric facilities are vacant, resulting in more temporary workers and fewer patients getting treatment.

Workers there got pay raises and bonuses last year, resulting in a lower turnover rate. But Mark Benton of the Department of Health and Human Services says more needs to be done.

"We're left with, still, challenges around competitive pay," Benton told a legislative committee. "We are not seeking, nor asking, that we match dollar-for-dollar for perhaps what Duke hospital may pay one of their nurses or physicians and other staff, but we very much need to be in the ballpark. And where we are is in one of the outlying parking lots."

State health officials also told lawmakers that North Carolina ranks 38th in the country for access to mental health care, and that all but six of the state's 100 counties have a shortage of mental health professionals. But they pointed to plans for improvement thanks in part to hundreds of millions of dollars allocated to mental health programs through the federal "signing bonus" that North Carolina received when it expanded Medicaid.

That's resulting in higher reimbursement rates for Medicaid providers, as well as new crisis facilities for areas where people experiencing mental health problems are often stuck waiting in emergency rooms.

The legislature returns to Raleigh later this month, and one of the agenda items for the "short session" is to make revisions to the state budget.

Colin Campbell covers politics for WUNC as the station's capitol bureau chief.
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