New Mexico has recently launched the United States鈥� first model, followed by Vermont and that are working to build capacity to support similar systems.

A national spotlight has also been cast on New York City鈥檚 efforts after promises on the campaign trail from Mayor Zohran Mamdani to expand free care for children as by the end of his term in late 2029.

The conversation is growing at several different levels, with some states focusing on pre-K access and others looking into providing care even earlier. But, most are grappling with major roadblocks in scaling larger 鈥� and universal 鈥� initiatives, including questions on funding models and accountability.

Shael Polakow-Suransky, a former chief academic officer at the New York City Department of Education, and the current president of Bank Street College of Education, spoke with 蜜桃影视 about childcare trends and what it鈥檒l look like to create higher quality programs as states look to expand access.

This conversation has been edited for length and clarity.

To kick off our conversation with the idea that there is a lot of movement around early childcare right now and accessibility to it, what are we seeing across the country and what are states investing in or considering legislation around?

We’re not getting any help right now from the federal government. During the Biden administration, it was the opposite. There were federal funds flowing to states specifically to do this work, and that’s part of how you got some really interesting, innovative stuff happening in states not that long ago.

Vermont is one of, I think, only two states now that have a really strong program to for early educators. Kentucky guaranteed for childcare workers that their own children or deeply subsidized care. 

New Mexico is one of the most interesting examples right now because in November 2025, they launched universal childcare. 

One of the things that is striking about their strategy is that they created a dedicated permanent revenue stream for it, 鈥� so it’s not conditioned on the federal government being able to support it, or an annual tax appropriation. That makes it stable in a way that’s unusual. They have also specifically said that competitive educator compensation is a goal which is really different.

D.C. is the other place that has done something similar to this. In 2018, they created a that had an explicit call around pay parity [for early care workers], and it gave people initial one time payments [up to $14,000]. Then, they created a salary scale based on educational attainment. They were also trying to push people to get the training that they needed to deliver at a high quality, and during the phase of that project, the employment in the sector grew by 7% and retention rose to over two thirds.

In most places, including New York City, early childhood folks鈥� turnover is five times the rate of what you see in K-12 settings. That turnover is a function of the low wages and and sometimes the lack of training as well, because if you’re not doing well in your job, you don’t want to stay in it.

In New York, a lot of our workforce is actually in poverty. More than half of New York’s early educators are relying on public assistance. We have more than 16,000 children statewide who can’t be served because of vacant positions and this is where we actually have state funding for childcare seats, but we don’t have people to fill those positions. So I think those models of D.C. and New Mexico are really worth looking at other states.

What about missed opportunities that aren’t being considered when lawmakers are drafting legislation or proposing new funding?

When you think about elected officials and who they’re accountable to, the most clear promise you can make is X number of seats for X communities. 

We’re going to have for 2-year-olds in New York City, 鈥� that is the thing that will stick in the minds of the public. That other layer, on quality, is harder to boil down into a sound bite.

When you create access, you could create a system that actually does damage if you don’t have quality. Quality is defined by what are the adults able to do with children once they have this time with them? We want it to be something that has real educational impacts, 鈥� and taking advantage of this incredible moment of brain development where 90% of your brain architecture is built by the time you turn 5.

What does high quality care look like? What are signs for parents to look for?

A quality learning environment for early childcare allows kids to move around freely and explore and interact with each other and with adults and the materials that are in the space, whether it’s blocks, or art supplies, or a dress up area, or a water or sand table.

In low-quality settings, a lot of times what’s happening is kids are in some way, physically restrained from moving, and this is done in the name of safety. In that low-quality setting, you don鈥檛 have enough adults, the physical layout of the space isn’t totally safe for a toddler to be wandering around and the kinds of things that are going to be interesting for that toddler to pick up and stick in their mouth are not available.

In a low-quality environment, that child is maybe sitting in a high chair or in a playpen, and there’s an iPad going that they’re looking at which is not able to interact with them and is not supporting that development. You may be keeping the child physically safe, but if they aren’t able to interact and move, their brain development is not going to progress the way it needs to.

You want to set up the physical space, and you want to have the staffing to support that flexible movement and exploration, because that is how our brains develop 鈥� through those types of interactions with people and with materials. If the person is so stressed, either because their own life is so stressful because they’re not able to make ends meet and or their work environment is so stressful because they’re understaffed and working really long hours, that connection is lost.

When we talk about opening seats across the country, what are the odds that these seats are going to be low quality care programs?

There’s been research done over the years that has looked at the quality of early childhood settings and in general, that number of really good settings are like 20 to 30% of what we have. That doesn’t mean that the other 70% are low quality 鈥� it’s a spectrum. My guess is probably only 10%, maybe 15%, fall into that low quality bucket, but there’s a lot in between that high quality and low quality that needs work.

How can states and lawmakers take more accountability when they are considering opening more spots up to ensure that it is leaning toward the highest level of care for the youngest kids, especially developmentally?

Building a living wage is the most important thing because that brings people into the workforce. It encourages people to stay in the workforce. And as people stay, they develop experience and relationships with children. You can’t do that without training. So that’s the other big piece of this, what are we doing to train people well?

From birth to 3, there’s not a requirement anywhere in the country that you have to have a teaching license to teach at that level and there can’t be that requirement given the current compensation structure. So then, what is the requirement? If you’re not going to ask people to have a bachelor’s degree or master’s degree, 鈥� how do you provide them with training and support that will enable them to accelerate learning and development for children?

The goal is that you build in the resources for professional development for the existing folks who are already in the field, and then resources for people to get trained as they enter the workforce as well. 

I’ll give you one example. Bank Street has partnered with New York City during the pre-K initiative because the state actually does require a master’s degree for pre-K teachers here and that’s a relatively new requirement, so there are a lot of teachers who were working before that requirement went into place, and are now out of compliance with that law.

The city asked us at Bank Street to design something specifically for that group that would be attuned to the fact that they already have lots of knowledge and skills and they don’t need to start from the beginning. 

We created something called the Advanced Standing Program, which is a mastery based program for teachers who are already pretty experienced, and so they can do it much more quickly than a normal master’s degree. They get credit for their experience, so the cost is lower, and it’s historically been paid for partially by the city or by nonprofits where the folks are working. 

So, creating those kinds of programs that are really responsive to the real needs of folks in this workforce, as opposed to a compliance requirement that pushes a lot of people away.

There’s some examples now of universal childcare, but in most states, it is pretty limited to low-income families or at a pre-K level. So, when we’re talking about this quality issue, I want to get into equity also. Childcare programs may be getting some of the highest needs students. How does the issue of quality play a role in development and readiness by the time these students enter the K-12 system? 

The achievement gap that we see in K-12 schools between wealthy and low-income students 鈥� which is usually like a 20 or 30 point spread in achievement when you look at third grade or eighth grade test scores or high school graduation rates 鈥� is visible beginning at 18 months.

If you study toddlers, the same exact graph shows up between upper-income and low-income children. So why is that? 

We know that’s exactly that moment where language development is happening in the brain, and so if a child is sitting in front of a TV all day by themselves, or iPad or and no one’s talking to them, no one’s interacting with them, then they’re going to be really low scoring around that language development.

There’s not much that’s different between upper income and lower income children except for the fact that upper income families have much more access to quality care. If we can provide that quality care across the income spectrum, there’s a shot at closing those achievement gaps later on.

We’ve talked about New York City a little bit, and I know through several decades, there’s been a push and pull around expanding this early childhood care access under each mayor. Can you talk a little bit about the history of what New York City has tried, what’s new now under Mamdani’s proposal and whether that will be effective or not?

One of my big regrets, I was senior deputy chancellor under Mayor [Mike] Bloomberg for his third term in office, and it was around that time that we started to expand pre-K, but it was a very modest expansion. As someone who came up as an educator in middle schools and high schools, I didn’t really know what I know now about the power of early childhood. I don’t think any of us at the DOE in those days, other than folks working in the early childhood division who weren’t at the decision making table, understood how powerful the impact on educational equity is if you invest in early childhood. 

It took Mayor [Bill] de Blasio making the pre-K commitment as part of his first mayoral campaign to make that the focus for the Department of Education and for the city as a whole. They added 60,000 new seats in pre-K, then expanded pre-K as well in the second term. 

Mayor [Eric] Adams made lots of promises about working on this but really didn’t move the ball. 

What Mayor [Mamdani] campaigned on is that there’ll be free childcare for kids from birth to 5. It鈥檚 beginning with expanding the number of seats for 3-year-olds and expanding 2-year-olds. It鈥檚 a fairly modest expansion in this first year, and I think the question that will face the mayor over the rest of this term is how do you get to that larger goal where everyone has access and and how do you do it in a way that pairs access with quality? 

I think they’re off to a good start.

I want to pose the question you said Mamdani鈥檚 team will have to answer. How do states lead large scale expansion and ensure quality as they try to expand to everyone?

One of the lessons that we learned from the pre-K expansion is that you need to pay attention to the existing ecosystem and not lose capacity as you build capacity. 

One of the downsides of the pre-K expansion during de Blasio’s term was that they put a lot of the seats into public elementary schools, and the teachers became part of the UFT. They got regular salary the same way any K-12 teacher, which is great, but then the nonprofits that were running childcare programs as part of the initiative didn’t have the funding to match those salaries, and so a lot of people left the nonprofit daycare centers 鈥� and even worse, family childcare, which are small businesses run out of people’s homes that usually serve children birth to 5, were not initially included in the strategy.

We actually saw a loss of childcare seats in the birth to 3 space when some of those folks went out of business. 

I think part of the solution this time around, particularly because we’re working with younger children, is how do you support family childcare as part of this? How do you help improve the quality and the economic viability of that? 

Last question just to wrap us up. What you had talked about during your time at the NYC Department of Education with not paying attention to childcare, I think is something that was universal for lawmakers early on too. This conversation has really picked up in the last five years or so. How likely is it to continue seeing such acceleration in this movement?

I think one of the interesting things about childcare is it’s a bipartisan issue in most places in the country. 

The governor of Ohio, a Republican governor, has done massive investments in early childhood. Nebraska, Louisiana, lots of red states have really prioritized this, and the reason why is that more than three quarters of families have both parents in the workforce, so people need childcare. They need a place for their children to be. They need to be able to afford it, and they want it to be safe, and they want their children to be learning.聽

From an educational equity standpoint, we need that quality in order to sort of solve our broader problems in terms of achievement gaps in our school system. 

We haven’t seen as much investment in the second Trump administration, but the first Trump administration actually saw the biggest increase in early childhood funding since the Clinton administration. Biden went even further. Those were both a Republican president and a Democratic president actively investing in this. We have Republican governors and Democratic governors actively investing in this.

This is something that really speaks to people, and so I think for that reason, we are going to continue to see new public funding flow to this. It may not come as fast as I would hope, but we’re on the trajectory in the right direction.

In the past year, Christian King, a doula based in Kansas City, has supported more than 40 mothers enrolled in Medicaid through their pregnancy, birth and postpartum.

In that role, she helps educate and support families about birth and babies, but her work also takes on a more nontraditional approach.

When one mother鈥檚 water was shut off at four weeks postpartum, King helped her find reconciliation services to turn the utilities back on. When another mom couldn鈥檛 afford car repairs, King found an organization in Raytown that provided financial assistance. She helped one client secure a car seat from the local health department and another fill her closet with baby clothes.

King, 35, hopes that soon, 鈥渏ust like going to the dentist and going to the eye doctor, obtaining a doula and having a doula present is also one of those things that you just have to have on your team as part of services for maternity.鈥�

Doulas do not deliver babies. They advocate for the physical and mental wellbeing of mothers and their families.

For the past 15 months in Missouri, anyone enrolled in Medicaid while pregnant and postpartum can have a doula by their side for free. Now, a group of bipartisan lawmakers are hoping to expand the program in an effort to continue combating the state鈥檚 poor infant and maternal outcomes.

鈥淭he statistics tell a devastating story of the lives lost that could鈥檝e been saved if we put in the proper measures,鈥� said state Sen. Barbara Washington, a Democrat from Kansas City who proposed one iteration of the . 鈥淭here are third-world countries that have better maternal mortality rates than we do.鈥�

The bill is estimated to cost around $300,000. While substantial amid a predicted state budget shortfall, state Rep. also filed legislation to expand the program, said she believes the long-term savings of having fewer Missourians who require medical attention will make up for the cost.

On average, 70 women die each year in Missouri during childbirth or in the first year postpartum. Of those deaths,

In Missouri, than women on private insurance, according to a 2024 report published by the state鈥檚 Pregnancy-Associated Mortality Review that looked at women who gave birth between 2017 and 2021.聽 A 2023 and also pointed to doulas as a solution.

In fall 2024, the Missouri Department of Social Services issued an , citing 鈥渁n immediate danger to the public health, safety or welfare of pregnant women in Missouri.鈥�

Since the program鈥檚 inception, there have been about 625 participants insured through Medicaid who accessed doulas during their pregnancy and postpartum, said Baylee Watts, a spokeswoman for the Department of Social Services. As of this month, 108 doulas were enrolled in the program.

鈥淭he department is encouraged by the level of engagement so far,鈥� Watts said in a statement. 鈥淎nd views the doula benefit as an important component of broader efforts to improve maternal health outcomes across Missouri.鈥�

Legislation filed by state Rep. Tara Peters, a Rolla Republican, has moved the farthest this year, clearing committee in February as part of a 聽Her bill seeks to increase the number of covered doula visits from six to 16.

The average out-of-pocket cost for a doula in Missouri is about $1,500, according to the Missouri Doula Association.

鈥淚鈥檝e just noticed how much extra care a doula can provide, especially for women in high need situations,鈥� said 鈥淒oulas can provide some great education and support for people who maybe don鈥檛 have the extra support.鈥�

This support can also look like serving as an interpreter between medical professionals and pregnant people, navigating insurance, ensuring access to nutritious food or coordinating transportation to medical appointments.

, who previously served as executive director of Monarch Family Resource Center in Farmington, said expanding the number of covered visits can be particularly helpful for women who experience postpartum depression in the year after giving birth.

Her legislation, like Peters鈥�, expands the number of reimbursable visits from six to sixteen, and includes access to doulas for prenatal, birth, postpartum and lactation support.

She said the legislation also hopes to correct some issues doulas have had getting full reimbursement after being in the room for a scheduled c-section, listed as a scheduled surgeries, a classification she said muddled the reimbursement process.

The Department of Social Services previously said the reimbursements could lead to savings for the state in the coming years, including by potentially reducing the Cesarean rate. Watts said it鈥檚 too early to get an accurate look at this result.

said doulas can be a lifesaving set of eyes and ears in homes where women experience domestic violence, a leading cause of pregnancy-associated deaths in Missouri.

鈥淭he doula birth worker can also have a voice in those situations and see what鈥檚 going on outside of that medical office,鈥� she said. 鈥淎nd maybe be able to provide some rescuing relief from dangerous situations for mom.鈥�

To be eligible, and certified through a national or Missouri-based doula training organization. From there, they will be added to a list of eligible doulas overseen by .

Sandra Thornhill, a social justice doula who has advocated in Jefferson City for better legislation for doulas, said it was beautiful to see this policy issue reach across the aisle. And she was happy to see some of the proposals pushing for increased visits, especially in postpartum.

She said it鈥檚 not a question of if doulas should be reimbursed, but of how the state honors the traditional practices and values of doulas in that process. She is wary of any policies that place community health workers under medical or state authority. Instead she hopes to see more collaborative models.

鈥滿y concern is not with recognizing doulas in the Medicaid policy, but with how the bill structures authority and governance over that work,鈥� said Thornill, who describes herself as a womb warrior and policy griot. 鈥淭he question is whether the policy structure strengthens community birth workers or will it place unnecessary burden or medical authority that doesn鈥檛 reflect the roots of the work.鈥�

But she said the progress made in acknowledging and supporting doula鈥檚 work in the past few years is striking, especially as many doulas live 鈥渂irth to birth鈥� as they struggle to pay the bills.

Prior to the state鈥檚 Medicaid reimbursement plan, to help families in need for free as they navigated growing their families.

鈥淭hey do it because they love their people and their community so much that they鈥檙e willing to make this great sacrifice,鈥� Thornhill said. 鈥溾�〩owever, it is not healthy. And it is not fair for the community to have to suffer like that when there are resources available to change that. But again, those resources cannot come with a slap on the wrist. They cannot come with a backlash of 鈥榥ow you鈥檙e under our thumb.鈥欌��

A representative with America鈥檚 Health Insurance Plans voiced opposition to Washington鈥檚 bill in a committee hearing last month.

鈥淲e are very concerned about issues with education, standardization and making sure doulas are all on the same page and we know exactly how they鈥檝e been trained,鈥� he said. 鈥淭here seems to be some resistance out there and a lot of independence within the organizations.鈥�

Washington鈥檚 legislation also seeks to ensure health benefit plans offer coverage for midwifery services. She said this is especially crucial in rural parts of the state, where families don鈥檛 have access to nearby hospitals with maternity wards.

鈥淐urrently, our law does not explicitly require private health plans to cover midwifery. This would close that loophole,鈥� Washington said, adding that this change would shift power back to patients to choose their own provider, especially in rural communities 鈥渨here the hospitals are closing at alarming rates.鈥�

is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.

鈥淒on鈥檛 underestimate the value of play,鈥� Hartwick College鈥檚 Laurel Bongiorno warns in a for the National Association for the Education of Young Children. Cognitive, social and literacy skills, along with vocabulary and physical abilities all get a workout when the little ones play. And while nobody invented playful learning, one of the world鈥檚 most influential champions was Loris Malaguzzi, founder of child care centers and preschools .

To learn more about play鈥檚 place in the Reggio Emilia approach, Early Learning Nation magazine spoke to Brenda Fyfe, dean and professor emeritus of the School of Education at . She serves on the board of the North American Reggio Emilia Alliance and co-edited .

Mark Swartz: When did you first encounter Reggio Emilia?

Brenda Fyfe: In 1990, I was teaching at Webster University鈥檚 campus in Iceland near the NATO base. Many Nordic countries had connected with Reggio Emilia long before anybody in the U.S. did. So I visited Italy, and I was awestruck. A Reggio classroom is a lovely place to be. You want to join the play; you want to play with everything. And yet there鈥檚 a sense of calm and peace. In part because it’s very soft and it doesn’t jump out and bombard you like some classrooms do with the primary colors and the letters all over the wall and that sort of thing. It’s soft and it’s peaceful, and yet it’s rich and stimulating, because there are materials there and there’s color, but it’s done in a way that helps you to calm down and not want to jump out of your chair. I returned every year until Covid.

MS: You belonged to a generation of educators who helped to popularize Reggio in the United States.

BF: Back then, all the literature that I could find was either in Icelandic or Italian. Lella Gandini was the key liaison between the U.S. and Reggio Emilia. She had been a doctoral student in Italy, and she brought knowledge of the Reggio Emilia approach and helped to organize an exhibit called , which highlighted the brilliance of children that they uncover and make visible through that exhibit. ( is also the title of an influential book.) Leila and I built partnerships and we created programs together. In St. Louis, I organized a group of educators from about five different schools, originally, to come together as a study group.

MS: Let鈥檚 talk about Reggio and play.

BF: calls play a child鈥檚 search for meaning. Play is the way that children deal with their reality and make sense of their world. And it gives them a sense of freedom, too, and agency. Children express themselves through materials, through music, movement, construction, sculpture, drawing, painting, all of what they call expressive languages.

MS: So it isn鈥檛 just for fun.

BF: And it鈥檚 never completely free play, either. The environment is set up; the materials are chosen. It’s not just let the kids go do whatever they want, you observe and document and then study it. Reggio founder Loris Malaguzzi (alongside the two co-teachers in the classroom).

It鈥檚 the idea of using materials to communicate ideas, feelings, thoughts and experiences. And it’s done in a playful way. Children are exploring and experimenting and they’re talking while they’re painting and they’re interacting with friends, and they’re looking at each other’s work and commenting on it.

MS: How can an educator tell the play is going the way it鈥檚 supposed to?

BF: When it’s really good play, you’re negotiating your experience. If it’s a dramatic play, for example, children are talking; they’re designing ideas; they’re talking about it with each other.聽 We talk about this idea of design, documentation and discourse as part of the negotiated learning process. Group play is a negotiation.

George Forman and Brenda Fyfe鈥檚 chapter in The Hundred Languages of Children

MS: These are life skills. Design, documentation and discourse are things you’re going to use in the workplace and with your family and then life later on.

BF: And even with the materials, you’re kind of negotiating your own understanding of it and your use of it by manipulating it.

MS: How does this concept apply to the youngest children?

BF: Even if infants and toddlers don’t have words, they’re watching. What are they looking at? How are they approaching it or how are they touching it?

MS: What are some of American Reggio鈥檚 innovations in recent years?

BF: The first one that comes to mind is called , from 2019, where they’ve looked at children exploring the outdoors. They’ve helped children to augment their playful observations with technology. They put digital cameras into the hands of children to take a photograph of what they see, and they come back to the images later and reflect on it. So play can be very sophisticated. Play with young children can involve materials, each other, but also technology.

MS: It鈥檚 a very demanding process for educators.

BF: Yes, and it鈥檚 also very energizing in the way it makes you slow down and listen to children. When most of us think about teaching, we picture a lesson plan and a sequence of experiences, and then closure. But rather than letting the plan drive you, you let it open you up to seeing what you didn’t anticipate.

MS: Could you say more about the teacher鈥檚 role?

Fyfe: The teacher gets involved without being intrusive, without being directive, but you get into the groove of the way the children are thinking. You want children to be in that space of being free to think and act in the moment. I always think of , co-founder of the field of positive psychology, who originated the concept of 鈥渇low.鈥� That’s the perfect image for me of what play is. We like to say the teacher’s role is to toss the ball in a way that the child wants to toss it back to you.