Spotlight: Home-Based Child Care

Like the rest of the country, North Carolina is in the midst of a child care crisis, one that has been developing for decades and was exacerbated by the Covid-19 pandemic and subsequent workforce challenges. Families are struggling to find and afford quality child care and preschool programs for their young children, and across the state, everyone - from families to business leaders to policymakers - is looking for solutions.

While there are no overnight fixes, there is a part of our child care ecosystem that has potential to meet the needs of more families – home-based child care. With this in mind, investing in opportunities to grow and strengthen home-based child care has become an emerging focus of the Blue Cross NC Foundation.

What is Home-Based Child Care
Home-based child care is broadly defined as child care in the provider’s home and includes both licensed family child care and unregulated family, friend, and neighbor care. It is the preference of many families due to its myriad strengths and its ability to meet their needs. Some of the benefits include:

  • Providing flexible hours for parents working 2nd and 3rd shift jobs.
  • Minimizing transportation challenges, particularly in rural areas.
  • Fostering a child care environment that shares the family’s cultural norms and values.
  • Offering more consistent relationships between child and provider.

Many parents’ preference for home-based child care were amplified throughout the pandemic due to the smaller number of children in these settings, increased flexibility, and ability to respond to enhanced concerns about safety.

Where there are Challenges, there is Opportunity
Unfortunately, the number of licensed family child care sites in North Carolina has diminished over the past two decades, dropping from nearly 5,000 to closer to 1,000 today. There are many reasons for this. Compared to their center-based peers, the workforce in these settings has less professional development opportunities, receives less support from the state’s child care infrastructure, and the licensing process presents additional challenges based on their setting. Furthermore, compensation is substantially lower than that of other educational professionals including center-based staff. At an average of only $9.09 per hour, there is no county in the state where this is considered a living wage.

Similar challenges are also facing family, friend, and neighbor care, the settings where the majority of young children in North Carolina – approximately two-thirds – receive care. This includes everything from grandparents and other relatives to friends, neighbors, nannies, and other small, informal providers. This widespread utilization results from a combination of family preference, barriers to licensure for some providers, and lack of access to regulated settings, including larger child care centers due to location, cost, or availability.

Despite its prominence and popularity, family, friend, and neighbor care providers receive virtually no support from the infrastructure that provides professional development and other services, such as access to subsidies, quality improvement incentives, or emergency aid grants. As a result, these providers are missing out on the opportunity to grow both as caregivers and early educators.


One promising approach to strengthening both types of home-based child care is the development of local networks that connect independently operated providers. These networks identify common needs among providers and link them with system supports.


One promising approach to strengthening both types of home-based child care is the development of local networks that connect independently operated providers. These networks identify common needs among providers and link them with system supports. Home Grown – a national organization committed to improving the quality of and access to care provided in homes – defines a home-based child care network as, “an interconnected group of providers and families that come together to enhance supports for home-based child care, including quality, access to services, and sustainability.”

In addition to the supports offered to providers, these networks are also positioned to advocate for policy changes that could further bolster this sector, such as addressing licensing barriers and opening avenues to better pay.

Seeing a lack of home-based child care networks in the state, in 2022, the Blue Cross NC Foundation responded and is currently supporting seven networks with three-year, $300,000 grants. Funded networks provide professional, business, and advocacy support for local providers and participate in a statewide Network Community of Practice to share learnings and to develop strategies for improving the policy, economic, and regulatory environments.

This is part of a larger Foundation effort focused on opening more child care and preschool opportunities to support young children, families, and the communities they live and work in by supporting and partnering with organizations who advocate for, and work directly with, them.

Home-Based Child Care Benefits Us All
With the necessary resources and support, home-based child care providers can be better equipped to provide the excellent, accessible, and affordable care families need.

Of course, parents and families are not the only ones who depend on this. Child care and preschool are pillars of North Carolina’s economy and its communities. Companies depend on child care to have a workforce, and families depend on child care so they can go to work, which helps in growing and strengthening our local communities and businesses. Without quality, affordable child care options, businesses may have smaller employee talent pools, as parents and caregivers are forced to turn down education and training opportunities or even leave the workforce. These benefits are multigenerational: when young children build a strong foundation of health and well-being during their earliest years, they are well-positioned for lifelong health and success.

Child care and preschool systems that meet the needs of all families, as well as the early care and education workforce are important building blocks to this foundation.


Learn more about the Foundation's focus in early childhood.