The Stories Behind the 2024 Early Childhood Checkup

By GEEARS for The Saporta Report

Last year, GEEARS launched the Annual Early Childhood Checkup, a quick, digestible reference to help policymakers, community leaders, and others measure statewide progress on key early childhood indicators.

The Checkup considers three broad categories that touch upon a young child’s life: Early Learning, Health, and Family Supports. And since no little ones exist outside of the context of their caretakers and communities, these indicators also factor in their families’ well-being. 

These data are critical to GEEARS’ advocacy. When we take hard numbers to our stakeholders, they can use them to support their proposed economic investments. They can also use them to measure policies’ success.   

But experience has shown us that stories matter just as much as data points.  

That’s why, to accompany the release of this year’s Checkup, we’ve asked two early childhood professionals to share their experiences. Child care provider, Angelique Dutch, and pediatrician, Angela Highbaugh-Battle, MD, work with young children and families every day. They know their struggles well and they’re advocating for policies that could help families thrive during their kids’ first five years. 

Read on for excerpts from these stories. For a more detailed read, click here.

Early Learning—Angelique Dutch, Director, APEC Learning Center 

The 2024 Early Childhood Checkup shows that only 5.2 percent of income-eligible children (per federal guidelines) received scholarships from Childcare and Parent Services (CAPS), Georgia’s child care subsidy program for working families with low incomes. Longtime child care provider Angelique Dutch sees the effect that that such low and unstable numbers have on her families, about half of whom receive CAPS scholarships. 

In her many years since founding the bright and homey APEC Learning Center on Cascade Avenue, Angelique Dutch has seen it happen time and time again—working families who achieve success and a pay bump are forced to pull their kids out of child care or quit their jobs to avoid losing access to Childcare and Parent Services (CAPS) tuition assistance. 

“You realize, ‘Because I’m working hard, I’m losing all my benefits,’” Dutch says. “‘The money I’m earning doesn’t offset the benefits that I lost.’ So, then you stop working. You have to stop working.” 

While a household might be able to bounce back from such a blow, Dutch says that their child’s lost time cannot be made up. 

“If you miss weeks or months out of your preschool development? That’s a long time in the life of a two-, three-, or four-year-old,” she says. “The preschool environment is critical and they’re not going to be ready for public school if you don’t give them that early foundation.” 

When it comes to Dutch’s business, where meeting quality standards requires a raft of expenses, CAPS funding can also be a mixed bag. 

“All the support is appreciated,” she says of the subsidies, “but literally what CAPS pays for will not even pay the teacher. It hasn’t bought me food, it hasn’t paid the light bill, it hasn’t bought a new crib.” 

If CAPS provider reimbursements rates were raised, Dutch says, it would make a tremendous difference.

“My rate for infant care is $325 [per week],” she says matter-of-factly. “CAPS is only paying me $169. Even at $325, I’m only paying my teachers’ salaries. I’m eating the other costs.”

Dutch would also like to see an increase in CAPS’ qualifying family income thresholds. And she’d love to see families get a grace period if they lose their benefits, much like COBRA health insurance. With such a policy, children wouldn’t be yanked out of their care situation while their parents seek new employment or deal with CAPS online forms, which can be prohibitively onerous, especially for households without computers. 

If fixes like these don’t happen? Dutch’s always placid expression goes a bit grim. 

“Eventually, we will have to consider no longer accepting subsidized care,” she says. “We’d have what I call a ‘boutique operation.’ Doesn’t that sound lovely? It sounds wonderful, except what about the 60% of children that I have enrolled now who’ll have no care or have low-quality care? I love the boutique operation but I just want all children to have access to it.” 

Click here to read a more detailed conversation with Angelique Dutch. 

Health—Angela Highbaugh-Battle, MD, Pediatrician and former President of the American Academy of Pediatrics’ Georgia Chapter

The 2024 Early Childhood Checkup shows that less than three-quarters of children received their recommended vaccine series by 35 months, a trend that has only worsened in recent years. On-time completion of this series prevents infectious diseases and serves as a proxy for regular, up-to-date well-child visits. We talked to pediatrician Dr. Angela Highbaugh-Battle about immunization and other challenges she sees families experiencing in Southeast Georgia.

When Dr. Angela Highbaugh-Battle sees the youngest patients at her pediatric practice in St. Marys, Georgia, myriad good things can come of the appointment. Highbaugh-Battle will, of course, track developmental milestones and administer little ones’ scheduled vaccinations and preventive screenings. She’ll compassionately counsel parents about nutrition, safety, sleep, and other important health topics. 

That in-person interaction also allows Highbaugh-Battle to spot when “something isn’t quite right” and have a conversation about it with the child’s parents or caregivers. This might lead to additional screening or early intervention. 

But here’s the challenge Highbaugh-Battle faces in her location in Camden County: Simply getting families into her exam room can be difficult. 

“The biggest barrier here is access,” Highbaugh-Battle says during a Zoom interview from her cheerful office. She quickly lists the challenges that can sideline her patients’ well visits. 

Transportation: There’s often limited access to or no public transportation options, Highbaugh-Battle says. If families don’t have a reliable car, it may be difficult for them to keep up with their appointments.

Provider Shortage: There are a limited number of providers in rural areas. In fact, there are a number of counties, including Camden’s neighbors, Charlton and Brantley counties, that don’t have a single pediatrician. What’s more, if a child needs specialized care, driving five hours to Atlanta is not feasible for most families. This ultimately leads to missed appointments or delayed care.

Medicaid Unwinding: During the COVID-19 emergency, children could continuously maintain their Medicaid coverage. Now that that policy has ended, thousands of Georgia families have seen their children’s insurance coverage disrupted. Medicaid eligibility reviews, which are again required every year, have led to children losing coverage for months at a time. This often happens due to administrative errors such as a caregiver missing a phone call or renewal notice, or the state failing to review eligibility documentation.  

As a rural doctor, Highbaugh-Battle says she has to go above and beyond to smooth the pathways for her families. First, she motivates parents to seek out healthcare by ensuring that they feel safe to ask questions and express their concerns without fear of judgment.

Next, she automates her systems, scheduling a child’s next appointment as they’re checking out of their current one, then sending appointment reminders via phone and text.

Highbaugh-Battle also says she seizes the moment when a child is in her office. “If a child comes in with strep,” she notes, “I make sure to look at their records and remind the parent when they’re due to return. Or I might say, ‘Hey, it’s time to schedule your next vaccine.’

“It’s gratifying to be part of these families during the critical early years,” she says. “I get to see them grow and develop. From the first time being afraid of me (I expect that) to greeting me with a hug a year later.”

Click here to read a more detailed conversation with Angela Highbaugh-Battle.