oversight

Military Child Care: DOD Is Taking Actions to Address Awareness and Availability Barriers

Published by the Government Accountability Office on 2012-02-03.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                United States Government Accountability Office

GAO             Report to Congressional Committees




February 2012
                MILITARY CHILD
                CARE
                DOD Is Taking
                Actions to Address
                Awareness and
                Availability Barriers




GAO-12-21
                                                February 2012

                                                MILITARY CHILD CARE
                                                DOD Is Taking Actions to Address Awareness and
                                                Availability Barriers
Highlights of GAO-12-21, a report to
congressional committees




Why GAO Did This Study                          What GAO Found
About a million military                        Out-of-pocket costs for military families who use DOD-subsidized child care are
servicemembers serve the United                 largely driven by policies that vary by service. DOD establishes income-based
States while raising a family, and many         fee ranges for on-installation child care, but each service sets its own fees and
need reliable, affordable child care.           discounts within these parameters. As a result, in school year 2010 the per-child
Paying for high-quality child care can          costs that families from the same income categories paid for on-installation care
be challenging for these families, so           varied by service and installation. For example, the monthly per-child cost for a
the Department of Defense (DOD)                 family with an income of $50,000 could have ranged from $335 to $518. Families’
offsets costs by subsidizing on-                costs for off-installation child care through private providers are also affected by
installation child care centers and
                                                policy differences among the services. All services offer subsidies for off-
offering subsidies for approved off-
                                                installation care that are intended to make families’ costs comparable to those for
installation care providers.
Deployments related to the wars in Iraq
                                                on-installation care. In an effort to offer benefits to more families, some services
and Afghanistan increased the demand            use a fixed cap to limit the subsidy amount. In school year 2010, the Air Force
for child care. The extent of military          and Navy capped their subsidies at $200 per child per month, and families in
families’ out-of-pocket child care costs        these services had higher average monthly costs for off-installation care than
for those using subsidized care are not         Army and Marine Corps families, and also had higher costs than what they would
known, and families may face barriers           have paid for on-installation care. For example, on average, Navy families using
to obtaining DOD-subsidized care.               off-installation care paid $87 more per month than they would have paid for on-
GAO was mandated to examine:                    installation care, while Army families paid $63 less. Other factors, such as the
(1) the out-of-pocket child care costs          number of children in care, also contributed to families’ costs for off-installation
paid by military families who use DOD-          care. DOD and the services’ recent policy changes reduced differences among
subsidized care; and (2) the barriers, if       and within services in families’ costs for on-installation care, and DOD plans to
any, to obtaining DOD-subsidized care,          further reduce these differences in the next 3 to 5 years. While the effects of
and what has DOD done in response.              these policy changes on individual families’ costs for off-installation care vary by
To address these objectives, GAO                family, families in services with fixed subsidy caps will likely continue to have
reviewed DOD policies and guidance;             higher average costs than families in services that do not.
interviewed officials from DOD, its             Military families face two main barriers to obtaining DOD-subsidized child care:
contractor that administers DOD’s off-          lack of awareness and insufficient availability. According to DOD officials and
installation child care subsidies, and
                                                based on GAO’s group discussions, some families remain unaware of subsidized
organizations that support military
                                                child care, particularly off-installation care, despite DOD’s efforts to provide
families; reviewed DOD fee data for
school year 2009-2010 (school year              information at pre-deployment briefings, and through other outreach efforts.
2010) and school year 2010-2011                 Families who are geographically isolated from an installation, such as reservists
(school year 2011); and analyzed child          and recruiters, may be less likely to be aware of subsidized care. The individual
care costs for a random probability             services have taken steps to increase awareness of DOD-subsidized child care,
sample of 338 families using off-               such as establishing positions for professionals who educate families about child
installation care in school year 2010.          care options. However, even families who are informed about DOD-subsidized
GAO conducted nongeneralizable                  child care may face barriers obtaining it due to a lack of available space at on-
discussion groups with military parents         installation centers and a scarcity of eligible child care providers off installation.
at two large military installations.            The shortage of on-installation child care spaces resulted, in part, from heavy
                                                deployment demands, and DOD has responded by approving construction
GAO is not making recommendations
in this report.DOD generally agreed
                                                projects that it anticipates will provide over 21,000 new child care spaces using
with the report’s findings and also             fiscal year 2008 through 2010 funding. DOD and the services have initiatives
provided additional information on              under way to increase the availability of eligible off-installation providers. In
several specific points in the report.          addition, DOD is developing an agencywide system that will provide
                                                servicemembers a central place to request both on-installation and off-installation
View GAO-12-21 or key components.               child care. DOD plans to pilot the system in the spring of 2012 and intends to
For more information, contact Kay E. Brown at   market it DOD-wide to servicemembers once it is fully implemented. The agency
(202) 512-7215 or brownke@gao.gov.
                                                is in the process of contracting for the development of a marketing plan.
                                                                                          United States Government Accountability Office
Contents


Letter                                                                                       1
               Background                                                                    4
               Military Families’ Child Care Costs Are Largely Driven by Policies,
                 Including Subsidy Caps, Which Vary by Service                               8
               Limited Awareness of DOD-Subsidized Child Care Programs and
                 Availability of Care Pose Barriers for Military Families                  17
               Concluding Observations                                                     27
               Agency Comments and Our Evaluation                                          29

Appendix I     Objectives, Scope, and Methodology                                          32




Appendix II    On-Installation Fee Ranges in School Year 2011                              38



Appendix III   Supplemental Data from Sample of Families Using DOD-Subsidized
               Off-Installation Care                                                       40



Appendix IV    Comments from the Department of Defense                                     42



Appendix V     GAO Contact and Staff Acknowledgments                                       44



Tables
               Table 1: Primary DOD-Subsidized Child Care Programs                           5
               Table 2: Average Monthly Costs per Family for Off-Installation Care
                        in School Year 2010, by Service                                    12
               Table 3: Subsidy Caps and Minimum Subsidies for Off-Installation
                        Care in School Year 2010, by Service                               14
               Table 4: OSD Income Categories and Fee Ranges for On-
                        Installation Care in School Year 2011                              15
               Table 5: Changes to Services’ Subsidy Policies for Off-Installation
                        Care in School Year 2011                                           17
               Table 6: Number of Families and Children in Sample, by Service
                        and Component                                                      40


               Page i                                             GAO-12-21 Military Child Care
          Table 7: Average, 10th Percentile, and 90th Percentile Annual Total
                   Family Incomes of Families Using Off-Installation Care in
                   Fiscal Year 2010, by Service                                                     40
          Table 8: Percent of Families Using Off-Installation Care with a
                   Servicemember Who Was Deployed in Fiscal Year 2010, by
                   Service                                                                          41
          Table 9: Average Monthly Costs per Child for Off-Installation Care
                   in School Year 2010, by Service                                                  41
          Table 10: Percent of Air Force and Navy Families Using Off-
                   Installation Care Affected by Subsidy Cap in School Year
                   2010                                                                             41


Figures
          Figure 1: OSD Allowable Monthly Fee Ranges and Ranges in the
                   Actual Fees Charged by Services for On-Installation Care
                   in School Year 2010, by Income Category                                           9
          Figure 2: Common Sources of DOD Child Care Information                                    18
          Figure 3: Determining Eligibility for DOD-Subsidized Off-
                   Installation Child Care                                                          26
          Figure 4: Office of the Secretary of Defense (OSD) Allowable
                   Monthly Fee Ranges and Ranges in the Actual Fees
                   Charged by Services for On-Installation Care in School
                   Year 2011, by Income Category                                                    38




          Abbreviations
          CDC               Child Development Center
          DOD               Department of Defense
          NACCRRA           National Association of Child Care Resource and Referral
                            Agencies
          OSD               Office of the Secretary of Defense


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          Page ii                                                      GAO-12-21 Military Child Care
United States Government Accountability Office
Washington, DC 20548




                                   February 3, 2012

                                   The Honorable Carl Levin
                                   Chairman
                                   The Honorable John McCain
                                   Ranking Member
                                   Committee on Armed Services
                                   United States Senate

                                   The Honorable Howard P. “Buck” McKeon
                                   Chairman
                                   The Honorable Adam Smith
                                   Ranking Member
                                   Committee on Armed Services
                                   House of Representatives

                                   About a million members of the United States’ armed services 1 are
                                   balancing the demands of serving our country and raising a family, and
                                   many need reliable, affordable child care. Deployments related to the
                                   wars in Iraq and Afghanistan have increased the demand for child care.
                                   Paying for high-quality child care can be challenging, so the Department
                                   of Defense (DOD) subsidizes some child care costs for military families.
                                   Families using DOD-subsidized care may pay less than they would pay
                                   for similar child care in the private market. Specifically, DOD subsidizes
                                   the cost of operating Child Development Centers (CDC) that provide child
                                   care on most military installations, allowing these centers to charge fees
                                   that are the same or lower than similar privately operated centers off-
                                   installation. However, if on-installation care is unavailable, DOD provides
                                   subsidies to reduce the fees that military families pay for care of
                                   comparable quality in the community (off-installation care). For example,
                                   such subsidies allow servicemembers geographically isolated from an
                                   installation, including members of the National Guard and Reserves and
                                   some active duty personnel such as recruiters or educators, to obtain
                                   DOD-subsidized child care. Although DOD subsidizes a portion of military
                                   families’ child care costs, the extent of out-of-pocket costs are not known,
                                   and families may face barriers obtaining DOD-subsidized care.


                                   1
                                    In this report “armed services” refers to the Departments of the Army, Navy, Air Force,
                                   and Marine Corps. For the remainder of the report we refer to the armed services as
                                   “services.”




                                   Page 1                                                        GAO-12-21 Military Child Care
The Congress, interested in learning more about DOD’s financial
assistance for child care, mandated in the National Defense Authorization
Act for Fiscal Year 2010 that GAO report on a number of questions
related to this assistance. 2 As agreed with your offices, we assessed out-
of-pocket child care costs for military families and barriers associated with
obtaining subsidized child care. In April 2011 we briefed your committees
on our preliminary findings related to these questions, which are covered
more fully in this report:

1. What are the out-of-pocket child care costs paid by military families
   who use DOD-subsidized child care?

2. What are the barriers, if any, to obtaining DOD-subsidized care, and
   what has DOD done in response?

To address our objectives, we reviewed the child care fee policies set by
DOD and the services for school years 2009-2010 (school year 2010) and
2010-2011 (school year 2011), 3 including the ranges of allowable fees
charged to families for on-installation care. Some aspects of the services’
fee policies, such as their methods of calculating subsidies for off-
installation care, were not contained in written policies. We obtained this
information through interviews with DOD and service officials. We also
obtained data from the services on the actual fees charged per child
using on-installation care in school years 2010 and 2011. In addition, we
analyzed these costs for families using off-installation care for a random
probability sample of 338 families from all four services in school year
2010 based on family files maintained by the contractor that administers
DOD’s off-installation child care subsidies, the National Association of
Child Care Resource and Referral Agencies (NACCRRA). 4 Because we
conducted our sample data collection in the spring of 2011, school year
2010 was the most recent school year for which data for a full school year
were available. This analysis allowed us to generalize our findings to all
families receiving DOD subsidies for off-installation child care in school



2
Pub. L. No. 111-84, § 573, 123 Stat. 2190, 2318.
3
 According to DOD officials, the school year may begin in August or September,
depending on the local school schedule. However, DOD normally requires that child care
policies for the new school year be implemented no later than September 30.
4
 Our sample included active duty servicemembers and members of the National Guard
and Reserves.




Page 2                                                     GAO-12-21 Military Child Care
year 2010. 5 In order to present data on costs for on-installation care that
covered the same time period as our off-installation care cost data, we
analyzed on-installation fee data for school year 2010. We also analyzed
changes to the on-installation fee ranges in school year 2011. We
conducted semi-structured discussion groups with military parents,
including parents who did and did not have their children enrolled in DOD-
subsidized child care, during site visits to Joint Base Lewis-McChord,
Wash. (Army/Air Force), and Marine Corps Base Camp Lejeune, N.C., in
order to identify barriers to obtaining DOD-subsidized child care. The
information obtained during these visits is illustrative and not
representative of each service or of DOD programs as a whole. We
selected large installations that had a Guard and/or Reserve presence
and had significant deployment activity. We provided DOD with criteria
that they used to select parents for our structured discussion groups. We
reviewed relevant policies and guidance, studies, and surveys of military
parents, and interviewed child and youth program officials with DOD and
each of the four services, including officials at service headquarters and
installations. 6 We also interviewed NACCRRA officials, researchers
knowledgeable about DOD child care programs, and officials from
national organizations that represent military families.

We conducted this performance audit from June 2010 through February
2012 in accordance with generally accepted government auditing
standards. These standards require that we plan and perform the audit to
obtain sufficient, appropriate evidence to provide a reasonable basis for
our findings and conclusions based on our audit objectives. We believe
that the evidence obtained provides a reasonable basis for our findings
and conclusions based on our audit objectives. For more information on
our scope and methodology, see appendix I.




5
 See appendix I for our sampling methodology.
6
 DOD defines an installation as a base, camp, post, station, yard, center, homeport facility
for any ship, or other activity under the jurisdiction of the Department of Defense, including
any leased facility. We use the term “installation” in this report to refer to any DOD
locations included in this definition that have on-site child care facilities. Similar to DOD
and the services, we use the terms “on-installation” and “off-installation” to distinguish
between child care facilities on and off of installations, respectively.




Page 3                                                         GAO-12-21 Military Child Care
             DOD has provided subsidized child care to military members and civilian
Background   military employees for decades. 7 Today, DOD-subsidized child care is
             widely considered to be a high-quality model for the nation. A recent DOD
             report said that the Military Child Care Act of 1989, 8 which created DOD’s
             current child care structure and was enacted in response to concerns at
             the time about quality and availability of services, focused on assuring
             high-quality services and expanding access through subsidies. 9 DOD-
             subsidized care assists military families in balancing the competing
             demands of family life, accomplishing the DOD mission, and improving
             the financial health of military families. However, DOD-subsidized child
             care is not guaranteed to all who need it, and the availability of such care
             depends on demand and the services’ budgetary resources. DOD’s goal
             is to meet 80 percent of the demand for child care. 10 Table 1 shows the
             primary DOD-subsidized child care programs that are available to families
             in all four services, although a few other service-specific programs exist.
             Most military families who receive child care assistance do so by using
             CDCs or other forms of on-installation care.




             7
              GAO, Child Care: How Do Military and Civilian Center Costs Compare?,
             GAO/HEHS-00-7 (Washington, D.C.: Oct. 14, 1999).
             8
              Pub. L. No. 101-189, Div. A, Title XV, 103 Stat. 1352, 1589, as amended.
             9
              Office of the Under Secretary of Defense, Department of Defense, Report of the Tenth
             Quadrennial Review of Military Compensation, Volume II: Deferred and Noncash
             Compensation (Washington, D.C.: July 2008). In a 1982 report, we highlighted several
             problems with DOD child care, including unsafe child care facilities and other issues,
             which led to a new DOD child care policy prior to the enactment of the Military Child Care
             Act of 1989. See GAO, Military Child Care Programs: Progress Made, More Needed,
             GAO/FPCD-82-30 (Washington, D.C.: June 1, 1982).
             10
               Based on a demand formula calculation, DOD estimates the approximate number of
             military children that will need child care; DOD’s goal is to meet 80 percent of that
             demand. The calculation is based on data DOD collects about military families and
             children such as the number of servicemembers’ children who are 12 and under, and
             related assumptions, such as the percentage of children living in different family types
             (e.g., single-parent families, and families in which both parents are servicemembers).




             Page 4                                                        GAO-12-21 Military Child Care
Table 1: Primary DOD-Subsidized Child Care Programs

Program                             Setting                                                                  Purpose
Child Development Center            On-installation child care centers certified,                            Provides high-quality full- or part-time
                                    inspected, and operated by DOD and the services.                         child care.
Family Child Care                   On- and off-installation care in military housing.                       Provides an alternative to CDC care if
                                    Providers—usually military spouses—are                                   CDCs are full or if families’ needs are
                                    trained and certified by the services, and the                           not met by CDCs. Some Family Child
                                    homes are inspected according to DOD and                                 Care may offer overnight, emergency,
                                    service requirements.                                                    or infant care, for example.
School Age Care                     On- or off-installation providers including CDCs,                        Provides before- and after-school care
                                    Family Child Care, youth centers, community-                             and summer/holiday care.
                                    based nonprofit entities, or schools. Providers
                                    must be certified or licensed, and inspected, by
                                    DOD or the state.
Operation Military Child Care       Off-installation child care providers licensed and                       Subsidizes the cost of off-installation
Military Child Care in Your         inspected by the state including child care centers                      care if on-installation facilities are full or
Neighborhood                        and family child care homes. Military Child Care in                      there is no installation nearby.
                                    Your Neighborhood providers are required to be                           Operation Military Child Care is
                                    accrediteda to ensure quality comparable to a                            intended for short-term care, primarily
                                    CDC. In practice, services may waive this                                during deployment.
                                    requirement if no accredited provider is available.
                                       Sources: Interviews with DOD officials and NACCRRA, DOD guidance on child development programs, DOD’s Military HOMEFRONT
                                       website (www.militaryhomefront.dod.mil/tf/childcare), and NACCRRA’s Military Programs website (www.naccrra.org/MilitaryPrograms)
                                       and brochures.
                                       a
                                        Accreditation is designed to improve the quality of early and school-age care programs. Accreditation
                                       systems require programs to meet standards that exceed minimum state regulatory requirements.
                                       Achieving accreditation involves extensive self-study and validation by professionals outside the child
                                       care program to verify that quality standards are met. Other eligible providers include family child care
                                       homes with a Child Development Associate–credentialed provider or a family child care home
                                       provider with an Associate’s degree or higher in Early Childhood Education or Child Development.
                                       The Child Development Associate credential is a widely recognized credential in early childhood
                                       education.


                                       Several additional subsidized child care programs have been adopted DOD-
                                       wide, such as programs specifically for injured servicemembers’ families,11
                                       and respite 12 and hourly care—both of which are intended to offer sporadic,
                                       rather than regularly scheduled care. In addition, services offer several


                                       11
                                         This report discusses costs for families using regularly scheduled DOD-subsidized child
                                       care programs, and therefore does not include discussion of families’ costs for respite and
                                       hourly care.
                                       12
                                         DOD offers 16 hours per month of free respite child care to the families of active duty
                                       and Reserve and Guard servicemembers who are deployed or meet other criteria, such as
                                       those undergoing a temporary change of station. DOD also offers care for family
                                       members with special needs as part of its Exceptional Family Member Program. We did
                                       not include this program in this review because it was not specifically child care.




                                       Page 5                                                                                 GAO-12-21 Military Child Care
service-specific subsidized child care programs. For example, Army Child
Care in Your Neighborhood, available only at specified installations, aims to
increase the availability of eligible community-based child care providers and
Air Force’s Extended Duty Care offers child care during nontraditional hours
to support servicemembers working extended or additional shifts to support
the military mission. The services acknowledge that some families may also
use youth development programs—programs outside of School Age Care,
such as recreation programs—as child care, although these are not required
to meet the DOD’s standards for child care 13 and they are not intended to be
used as such.

The Office of the Secretary of Defense (OSD) establishes eligibility criteria
for subsidized child care and provides oversight and guidance to the
services, which each administer their own child care programs. For example,
OSD defines the following groups as eligible for military child care programs:
active duty military personnel, DOD civilian personnel, reservists on active
duty or during inactive duty personnel training, and DOD contractors.14 In
fiscal year 2010, there were approximately 1 million servicemembers with 1.8
million children ages 13 and under, according to our analysis of data from the
Defense Manpower Data Center. 15 According to DOD, its child care system
is serving about 200,000 children from birth to age 12, and NACCRRA
records indicate that in fiscal year 2010, about 25,000 of these children were
served in subsidized off-installation care. OSD specifies that first priority be
given to active duty military and DOD civilian personnel who are either single
parents or whose spouse is employed on a full-time basis outside the home
or is a military member on active duty. 16 However, OSD officials told us that
they are in the process of revising this policy. The revision under
consideration broadens the range of those in first priority status, adding
surviving spouses of servicemembers deceased while on active duty, among
other groups.



13
     Youth development programs must meet a separate set of standards.
14
 DOD Instruction 6060.2(4.3). Reservists include members of the Reserves and the
National Guard.
15
  These counts include members of all reserve categories, including those who were not
on active duty or in personnel training. Therefore, not all of these servicemembers and
their children were eligible for DOD child care programs.
16
  DOD Instruction 6060.2(4.2 and 4.3). Some DOD child care programs have other
eligibility requirements. For example, Operation Military Child Care and Military Child Care
in Your Neighborhood are primarily for servicemembers, rather than civilians.




Page 6                                                        GAO-12-21 Military Child Care
OSD also sets standards for provider eligibility for DOD’s off-installation
child care subsidies. DOD requires that providers under Military Child
Care in Your Neighborhood, intended for longer-term care periods, be
nationally accredited, to help ensure they are comparable in quality to
DOD’s Child Development Programs, such as CDCs. According to DOD
officials, child care can be considered accredited under a number of
different national accreditation and state child care quality programs,
which help ensure that child care providers meet quality standards.
Operation Military Child Care is intended for families of deployed
servicemembers, and DOD requires that, at a minimum, providers be
licensed and inspected annually.

OSD sets allowable ranges for the fees that families pay for on-installation
child care at CDCs, within which the services must set their fees. In contrast
to private providers, who generally set fees based on a child’s age, OSD sets
fee ranges based on total family income. 17 OSD sets two fee ranges—one
for standard-cost areas, and one for high-cost areas, or areas with high
market rates for child care. Installations in high-cost areas must pay higher
salaries to retain qualified child care staff, and are allowed to charge higher
fees to help cover these additional personnel costs. The services have some
flexibility in how they set their fees for on-installation child care within the
ranges set by OSD. For on-installation care, a family’s cost is the fee that the
service or installation sets minus any fee reductions, such as discounts for
multiple children in care.18 Other factors affect family-level costs, such as
family size and the number of hours that children are in care.

The subsidies services offer providers for off-installation child care are
intended to provide benefits comparable to those that families would
receive for on-installation care. As with fees for on-installation care,
however, the services have the ability to determine the extent to which
they subsidize the cost of off-installation care. The services contract with
NACCRRA to administer these subsidies, which NACCRRA pays directly
to DOD-approved child care providers. A family’s cost for off-installation
care is the portion of their provider’s fee not covered by the subsidy.


17
  Total family income includes both the income of the servicemember and the
servicemember’s spouse, if applicable.
18
  In school year 2011, all four services offered a multiple child discount of up to 20 percent
for additional children in care as well as discounts for families experiencing financial
hardship. The Army also offered a 20 percent deployment discount, and both the Army
and Navy offered discounts for families with injured servicemembers.




Page 7                                                         GAO-12-21 Military Child Care
Military Families’
Child Care Costs Are
Largely Driven by
Policies, Including
Subsidy Caps, Which
Vary by Service

For On-Installation Care,     As a result of services’ policies, the per-child monthly cost of on-
Services’ Policies Resulted   installation care at a CDC for families within the same income category
in Variations in Per-Child    varied by as much as $230 in school year 2010, depending on their
                              service and installation (see fig. 1). However, the per-child monthly costs
Costs                         for most families in the same income category varied within a smaller
                              range. For example, the per-child monthly cost for on-installation care for
                              a family with an annual income of $50,000 could have ranged from $335
                              to $518 in school year 2010; however, for families in this income category
                              at most military installations with CDCs, 19 the per-child monthly cost was
                              within the OSD standard fee range of $335 and $413. 20




                              19
                                In school year 2010, 64 percent of military installations with CDCs charged fees within
                              OSD’s standard fee range, while over a third charged fees within OSD’s high-cost range.
                              In school year 2011, the number of military installations with CDCs that charged fees
                              within OSD’s high-cost range declined to about 11 percent.
                              20
                                Because these data are at the child level, they cannot be used to draw conclusions
                              about costs at the family level for on-installation care in school year 2010, since individual
                              families may have had more than one child in care. In addition, these fee data do not
                              include any fee reductions offered by the services.




                              Page 8                                                          GAO-12-21 Military Child Care
Figure 1: OSD Allowable Monthly Fee Ranges and Ranges in the Actual Fees Charged by Services for On-Installation Care in
School Year 2010, by Income Category




                                        Page 9                                                 GAO-12-21 Military Child Care
Note: Fees are for full-time child care at CDCs, and do not include any fee reductions that individual
families may receive. Because high-cost installations were allowed to calculate their fees by
increasing the standard fee by the percentage of their cost-of-living allowance, two Air Force
installations, three Army installations, and one Marine Corps installation with very high cost-of-living
allowances charged fees that were above the OSD high-cost range. All other installations charged
fees within the OSD ranges. OSD fee policy sets ranges for weekly fees, and all of the services
except the Army set and charge fees on a weekly basis. Fee ranges for all services except the Army
have been converted to monthly terms using calculations that assume a 365-day year and an equal
number of days per month. Families’ actual monthly costs will vary slightly depending on the length of
the month. In addition, all Army installations allow families 2 weeks of vacation per year, during which
they do not pay child care fees if their children are not in care. Army families’ monthly fees are
calculated such that families pay more during the other weeks of the year to make up for the two
weeks of vacation. We recalculated Army fees without this vacation credit to make them comparable
to other services’ fees, which are generally not reported in this form. Due to rounding, in a few
instances the services’ fee ranges appear slightly lower or higher than the OSD fee ranges.
a
 One Army installation charged Category I families $182 per month and one charged $193. All other
Army installations charged families in this income category $188 per month.


The services have different policies for setting fees within the ranges set
by OSD. In school year 2010, the Air Force, Army, and Marine Corps all
allowed installation commanders to set fees for on-installation child care,
based on factors such as local market rates for child care. Most
installations set their fees within the OSD standard fee ranges.
Installations in high-cost areas, however, could set their fees using the
OSD high-cost fee range, or by increasing the standard fee by the
percentage of their cost-of-living allowance, which sometimes resulted in
fees that were above the OSD high-cost range. 21 In contrast to the other
services, the Navy set one fee per income category for all of their
standard-cost installations and another fee per category for high-cost
installations. In addition, the services have the discretion, within DOD-
prescribed policy, to set their own policies regarding the fee reductions
they offer to families, which generally apply only to on-installation care. 22
For example, services may offer fee reductions for families with multiple
children in care, families with a deployed servicemember, families with
injured servicemembers, and families experiencing financial hardship.




21
  The services are allowed to charge higher fees at high-cost installations under DOD
Instruction 6060.2, section E3.6.3.5. According to OSD, in addition to standard fee ranges,
in school year 2010 it set high-cost fee ranges for installations in high-cost areas, but also
allowed installations to adjust the standard fee by the percentage of their cost-of-living
allowance, post differential, or locality pay. OSD officials said that, beginning in school
year 2011, they set a single set of high-cost fees, which all high-cost installations are now
required to charge.
22
    The Army offers fee reductions for both on-installation and off-installation care.




Page 10                                                               GAO-12-21 Military Child Care
For Off-Installation Care,   In school year 2010, 23 families using off-installation care 24 in the Air Force
Families in Services with    and Navy, which capped the monthly amount of subsidy a family could
Fixed Subsidy Caps Had       receive at $200 per child, had higher average monthly child care costs
                             than did families in the Army and Marine Corps, which did not have fixed
Higher Average Costs in      subsidy caps. 25 Across all services, on average, military families paid
School Year 2010 than        about $556 per month for DOD-subsidized off-installation care (see table
Families in Other Services   2). 26 However, the average monthly costs for Air Force and Navy families
                             were $787 and $734, respectively, compared to $501 and $556,
                             respectively, for Army and Marine Corps families. In addition to fixed
                             subsidy caps, several other factors affected families’ costs for off-
                             installation care, including fee rates charged by private providers.




                             23
                               We drew our sample from families using off-installation care at some point from October
                             1, 2009, through September 30, 2010. Because we conducted our sample data collection
                             in the spring of 2011, school year 2010 was the most recent school year for which we
                             could collect a full school year of data.
                             24
                               When we refer to “off-installation care,” we are referring to off-installation, private child
                             care providers who receive DOD child care subsidies to serve military families.
                             25
                               Our data on these families’ costs only include the fees families paid to providers (minus
                             the subsidy amount paid by DOD on their behalf). Families may have additional child care
                             costs such as registration fees.
                             26
                               GAO’s sample of families receiving subsidies for off-installation care in school year 2010
                             provides data on their monthly child care costs at the family level. Because families may
                             have had more than one child in care, these costs are not directly comparable to the costs
                             per child for on-installation care.




                             Page 11                                                           GAO-12-21 Military Child Care
Table 2: Average Monthly Costs per Family for Off-Installation Care in School Year 2010, by Service

                                    Average difference      Average cost for                                          Average cost for off-
                                   between cost for off- off-installation care                Average cost for off-     installation care as
                Average cost for installation care and as a percentage of                      installation care as  percentage of private
                  off-installation       estimated on-          estimated on-                 percentage of family provider fee (fee before
Service                      carea     installation feeb      installation feec                            incomed     subsidy reduction)e
Allf                        $556                        -$38                           93.9                    8.7                        69.6
Air Force                    787                         +48                       110.9                      11.4                        78.1
Army                         501                         -63                           88.9                    7.7                        69.2
Marine Corps                 556                         -59                           92.2                    9.3                        60.3
Navy                         734                         +87                       116.0                      12.3                        77.7
                                          Source: GAO analysis of data from NACCRRA.

                                          Note: GAO’s sample of family files included families of activated members of the National Guard and
                                          Reserves who were receiving DOD subsidies for off-installation care. These families were
                                          categorized with their respective services for the purpose of our analysis.
                                          a
                                              The 95% margins of error for these estimates range from +/- $45 to $93.
                                          b
                                              The 95% margins of error for these estimates range from +/- $28 to $57.
                                          c
                                              The 95% margins of error for these estimates range from +/- 3.9 to 8.6 percentage points.
                                          d
                                              The 95% margins of error for these estimates range from +/- 0.6 to 1.5 percentage points.
                                          e
                                              The 95% margins of error for these estimates range from +/- 1.3 to 5.2 percentage points.
                                          f
                                          The averages are weighted to adjust for unequal probabilities of sample selection across services. As
                                          a result, the average for all families should not equal the unweighted average across services.


                                          Air Force and Navy families had higher average costs by other measures
                                          as well. For instance, families in these services using off-installation care
                                          paid more, on average, than the estimated amount they would have paid
                                          for on-installation care (by 11 percent and 16 percent, respectively). 27 In
                                          addition, on average, Navy families’ costs for off-installation care were 12
                                          percent of their family income, while the average Army family’s costs
                                          were 8 percent of their family income. Air Force and Navy families also
                                          paid a higher percentage of their private providers’ fees (the fee before
                                          being reduced by the subsidy), on average, than Army or Marine Corps
                                          families. 28



                                          27
                                            Because we estimate the average difference for Air Force families to have ranged from -
                                          $9 to $104 in 95 percent of the samples we might have drawn, there is a small chance
                                          that the estimated higher amount paid for on-installation care is caused by sampling error.
                                          28
                                            All of the differences between families in the Navy and Air Force and Army and Marine
                                          Corps discussed in this paragraph are significantly different from zero at the α = .05
                                          confidence level.




                                          Page 12                                                                GAO-12-21 Military Child Care
Families’ costs for off-installation care are affected not only by subsidy
caps, but also by the fees services charge for on-installation care.
Generally, the subsidy amount is the fee charged by the private provider
minus the estimated amount that a family would have paid for on-
installation care at a CDC. 29 For example, if an off-installation provider
charges $1,000 per month, and a family would have paid $600 per month
on installation, the subsidy amount would be $400 (if there is no subsidy
cap), and the family would pay the same amount they would have paid on
installation: $600. However, in school year 2010, the Air Force and Navy
set subsidy caps, or limits, on the per-child subsidy for off-installation care
in order to offer benefits to more families. As a result, some families in
these services paid more for off-installation care than they would have
paid on installation. In the example above, if the family was in the Air
Force or Navy, which both had fixed subsidy caps of $200 per month in
school year 2010, the family would have paid $800 per month (the
provider rate of $1,000 minus the subsidy of $200), which is $200 more
than they would have paid on installation. The Army also used subsidy
caps in school year 2010. However, in contrast with the Air Force and
Navy, the Army’s intention was that a family’s subsidy would only be
capped if they used private providers who charged rates above what the
Army considered reasonable for high-quality care in their local market.
The Army caps varied from $153 to $2,576, depending on a number of
family factors, such as total family income. The vast majority of these
caps were above $200, and over half were above $500. Thus, Army
families were likely less affected by their service’s caps than were Navy
and Air Force families, as suggested by the lower average costs of Army
families in our sample. 30

In addition to fixed caps, other factors also affect families’ costs for off-
installation care, including minimum subsidies, family factors, and
provider rates. Three of the four services offered minimum subsidies in



29
  Beginning in July 2011, rather than calculating the subsidy amount in this manner, the
Marine Corps began providing a subsidy of $250 per month to all eligible families using
full-time, off-installation child care.
30
  Army officials said they replaced the subsidy caps with provider rate caps beginning in
school year 2011 because these caps are much easier to administer and this type of cap
helps ensure that funds support families who need assistance. They said that, in contrast,
their subsidy caps were difficult to manage and, as a result, were not accurate or
comprehensive enough to ensure fee equity for all families or to provide sufficient fee
assistance for all who needed it.




Page 13                                                      GAO-12-21 Military Child Care
school year 2010, 31 which families received even if their off-installation
providers charged less than they would have paid on installation (see
table 3). Army officials said that they offered minimum subsidies to
encourage families living off installation to participate in DOD-subsidized
child care programs. Other factors that affect off-installation costs include
family income, which is a factor in the services’ subsidy calculations, 32
and other family factors such as the number and ages of children in care
and the amount of time that they are in care, which may affect how much
a family pays in fees to a given provider. The fee rates charged by private
providers, which are influenced by child care supply and demand as well
as the geographic location of the local community, affect costs for some,
but not all families. In the absence of subsidy caps, provider rates do not
affect costs, since the family’s subsidy covers the full difference between
their provider rate and estimated on-base fee. For families in services
with subsidy caps, however, the subsidy may not cover the full difference,
in which case families with higher provider rates will have higher costs.

Table 3: Subsidy Caps and Minimum Subsidies for Off-Installation Care in School
Year 2010, by Service

                                        Subsidy cap
    Service                             (per month)                                Minimum subsidy (per month)
    Air Force                                       $200                                                        $50
    Army                                      Variablea          $50 for part-time care; $100 for full-time care
    Marine Corps                                    None                                                       None
    Navy                                            $200                                                        $50
Source: GAO analysis of information provided by the Air Force, Army, Marine Corps, and Navy.
a
 Ranged from $153 to $2,576, depending on geographic location, family income, child’s age, and type
of care.




31
 The Marine Corps did not have an official minimum subsidy policy in school year 2010.
However, a NACCRRA official said that they offered a minimum subsidy of $100 to Marine
Corps families.
32
  The subsidy calculation takes into account an estimate of what the family would have
paid for on-installation care, and fees for on-installation care are based on family income.
Because the Marine Corps began offering $250 a month to all eligible families in July
2011, family income is no longer a factor in Marine Corps families’ costs for off-base care.




Page 14                                                                                 GAO-12-21 Military Child Care
Policy Changes Will Likely     Recent and planned changes to OSD and the Army’s fee policies will
Reduce Differences among       continue to reduce variation in the amount families in the same income
Services in Families’ Costs    category pay for on-installation care. In school year 2011, OSD revised
                               the fee ranges for the first time since school year 2005 to account for
for On-Installation Care,      inflation and increases in servicemembers’ incomes and to achieve a
but Effects on Off-            more equitable distribution of fees for military families. Specifically, OSD
Installation Costs Will Vary   divided the top income category into four categories, increased the
                               maximum income for each category, and increased both the minimum
                               and maximum fees for all categories except Category I (see table 4).
                               Under the new fee structure, OSD set a single fee per income category
                               for high-cost installations, which all high-cost installations are now
                               required to charge.

                               Table 4: OSD Income Categories and Fee Ranges for On-Installation Care in School
                               Year 2011

                                Category                                                OSD fee range               OSD fee
                                                              Family income       (standard cost areas)     (high-cost areas)
                                I                                   $0 – 29,400              $191 - 256                   $269
                                II                          $29,401 – 35,700                 $261 - 322                   $339
                                III                         $35,701 – 46,200                 $326 - 391                   $413
                                IV                          $46,201 – 57,750                 $395 - 456                   $478
                                V                           $57,751 – 73,500                 $461 - 526                   $552
                                VI                          $73,501 – 85,000                 $530 - 565                   $595
                                VII                       $85,001 – 100,000                  $569 - 578                   $608
                                VIII                    $100,001 – 125,000                   $582 - 591                   $621
                                IX                                   $125,001+               $595 - 604                   $634
                               Source: GAO analysis of data provided by OSD.

                               Note: Fee ranges have been converted to monthly terms using calculations that assume a 365-day
                               year and an equal number of days per month. Families’ actual monthly costs will vary slightly
                               depending on the length of the month.


                               The impact of these revisions on military families’ costs for on-installation
                               care varied depending on families’ service, installation, and income. In
                               general, however, the new OSD fee policy reduced the variation in the
                               per-child monthly cost for families in the same income category using on-
                               installation care among and within services. For example, while in school
                               year 2010 the per-child monthly cost for on-installation care for a family
                               with an annual income of $50,000 could have varied from $335 to $518




                               Page 15                                                           GAO-12-21 Military Child Care
(see fig. 1), in school year 2011 the per-child monthly cost for families
with the same income could have varied from $358 to $478 33 (see app. II,
fig. 4 for the full range of fees charged by the services in school year
2011). Costs for families with this income at most installations were within
the OSD standard fee range of $395 to $456 (see table 4).

OSD officials said that they are working with the services to transition in
the next 3 to 5 years toward a DOD-wide fee policy like the one currently
used by the Navy, with one fee per income category for standard-cost
installations, and another fee per category for high-cost installations.
According to these officials, the new fee policy implemented in school
year 2011 is the first step in this transition.

OSD’s changes to its fee policy and additional changes the services have
made to fee policies for off-installation care affect costs for some families
using off-installation care, but the extent of these effects is largely
unknown. The new OSD fee ranges affect costs for families using off-
installation care, as well as on-installation care, since the on-installation
fee rates are used to calculate subsidies for off-installation care. In
addition, all of the services have recently made changes to their off-
installation fee policies that make these policies more consistent in some,
but not all, respects. See table 5 for a summary of these changes.
Subsidy minimums are one area where the services’ subsidy policies for
off-installation care are not consistent, since Navy and Air Force families
receive a minimum of $10 per child per month, all Marine Corps families
eligible for full-time care receive $250 per child per month, and Army
families no longer receive a minimum subsidy. Given that the average
costs for families in our sample in services with $200 subsidy caps were
higher than those for other families, the average costs of Marine Corps
families using off-installation care are likely to rise with the
implementation of the Marine Corps’ $250 subsidy cap. Some Marine
Corps families, however, will see a decrease in their costs if they
previously received a subsidy of less than $250 per child per month. In
general, the effects of these subsidy policy changes will vary by family. In
particular, the effects will vary for families in services with subsidy caps,



33
  The Army obtained permission from OSD to allow certain installations that had been
charging rates at the lower end of the previous fee ranges to charge rates below the new
fee ranges in school year 2011, to prevent families at these installations from experiencing
large fee increases. Consequently, the lower end of the range of fees actually charged by
the services is lower than the minimum OSD fee for this, and other, fee categories.




Page 16                                                       GAO-12-21 Military Child Care
                          because costs for these families are driven partly by private provider fees,
                          which vary considerably regardless of the services’ policies.

                          Table 5: Changes to Services’ Subsidy Policies for Off-Installation Care in School
                          Year 2011

                              Type of policy               Policy change
                              Subsidy minimums             Air Force and Navy: Reduced minimum subsidy from $50 to $10
                              (per month)                  per child.
                                                                                                 a
                                                           Army: Discontinued minimum subsidy.
                                                           Marine Corps: Began providing all eligible families with the same
                                                                                             b
                                                           subsidy amount of $250 per child.
                              Subsidy caps (per            Air Force and Navy: Increased subsidy cap to $225 per child.
                              month)                       Army: Replaced variable subsidy caps with caps on provider
                                                                  c
                                                           rates.
                                                           Marine Corps: Began providing all eligible families with the same
                                                           subsidy amount of $250 per child (i.e., cap of $250 per child).
                          Source: GAO analysis of information provided by the Air Force, Army, Marine Corps, and Navy.
                          a
                           Under the new Army policy, families whose per-child subsidy amount is less than $10 do not receive
                          a monthly subsidy. Instead, the Army subsidizes these families’ registration fees (up to $150 per
                          child) and pays the provider rate for up to 2 weeks a year while the family is on vacation.
                          b
                           Families with monthly provider rates less than $250 per child receive the actual child care fee
                          amount paid, and those with children in part-time care receive a prorated subsidy amount per child.
                          c
                           Under the provider rate cap, the Army will only subsidize provider rates of up to $1,800 per child per
                          month. If a servicemember can justify that there is no other child care available, and his or her only
                          option is to use a provider who charges a fee above this cap, the Army will make an exception in
                          these cases.



Limited Awareness of
DOD-Subsidized Child
Care Programs and
Availability of Care
Pose Barriers for
Military Families

Even with Outreach        Although DOD provides information about subsidized child care programs
Initiatives, DOD Faces    through a number of sources, DOD officials and military parents cited
Challenges Educating      limited awareness of these programs as a key barrier to their use. DOD
                          uses many outreach methods, such as deployment briefings and other
Military Families about   events, brochures and ads, e-mails to servicemembers, staff assigned to
Child Care Programs       provide child care information, and Internet avenues, including websites



                          Page 17                                                                                 GAO-12-21 Military Child Care
                                      and social media. Figure 2 shows common sources of DOD child care
                                      information.

Figure 2: Common Sources of DOD Child Care Information




                                      Page 18                                       GAO-12-21 Military Child Care
a
 The Yellow Ribbon Reintegration Program was established by the National Defense Authorization
Act for Fiscal Year 2008, Pub. L. No. 110-181, § 582, 122 Stat. 3, 122. The purpose of the program is
to provide the National Guard and Reserve members and their families information and activities to
facilitate access to services supporting their health and well-being during the entire deployment cycle.
These services include services for children, which can include child care.
b
 The John Warner National Defense Authorization Act for Fiscal Year 2007, Pub. L. No. 109-364, §
675, 120 Stat. 2083, 2273, authorized the Joint Family Support Assistance Program. The purpose of
this program is to provide various types of assistance to families of servicemembers, including
financial and material assistance and mobile support services. DOD funded Joint Family Support
Assistance Program teams at National Guard Joint Force Headquarters in 15 pilot states in
November 2007, and expanded to all states and territories in September 2008.


DOD officials stated that while military families living on or near an
installation likely know about child care available through CDCs and
Family Child Care, they may not know about other on-installation child
care programs, such as respite care. Furthermore, both those living on or
near an installation and those living far from an installation may not know
about off-installation programs. For example, many servicemembers we
spoke with did not know about DOD-subsidized off-installation child care.
In addition, those who knew about the DOD-subsidized off-installation
programs had not always learned about them when they needed child
care. For example, two servicemembers we spoke with said that they had
learned about off-installation programs, but only through the community-
based provider they were using without benefit of DOD subsidies. One of
these servicemembers said that he had used a community-based
provider for a number of months before the provider told him about the
DOD subsidy program, and this was only when he notified the provider
that he no longer planned to use its services because he could not afford
the child care fees charged. Also, families that learn about DOD-
subsidized off-installation child care programs may not be aware of the
eligibility requirements of the programs. For example, officials at the
National Military Families Association told us that many military families
that heard about DOD off-installation subsidized child care believed that
the programs are needs-based, and thus assumed that they were not
eligible for them because their income was too high, even though the
programs are not limited to low-income families. Similarly, two military
spouses we spoke with incorrectly assumed that only those with low
incomes were eligible for such subsidies.

DOD faces a number of challenges to educating military families about
DOD-subsidized child care, particularly off-installation care. These
challenges include the large quantity of information servicemembers
receive during briefings, the timing of information provided, fewer
opportunities off installation to educate servicemembers about DOD-
subsidized programs for those geographically isolated from an



Page 19                                                               GAO-12-21 Military Child Care
installation, and fragmented child care application procedures. DOD and
the services have taken a number of steps to address these challenges.

•     Quantity of information received. DOD officials and an organization
      representing military families told us that information on DOD-
      subsidized child care programs is frequently provided at pre-
      deployment or other briefings, but because these briefings are often
      lengthy and cover multiple topics, servicemembers often do not retain
      information about child care. In 2007, we reported that DOD had a
      similar concern regarding briefings provided at mobilization sites and
      demobilization sites, which DOD considers to be primary educational
      tools. DOD officials said then that these briefings are often so full of
      critical information that it is difficult for reservists to absorb all of the
      details of its health care insurance program. 34 In fact, several
      servicemembers we met with noted that they tune out or become
      overwhelmed by long briefings and therefore do not retain much of the
      information, such as on child care.

      DOD officials recognize this concern and said that they try to ensure
      that military families learn about DOD-subsidized child care by
      providing them with many opportunities, beyond briefings, to learn
      about these programs. For example, because DOD considers
      command unit leadership to be key to ensuring readiness, including
      supporting spouses and families, DOD has taken steps to help units
      provide child care information to their servicemembers and families
      through unit contacts. Officials from all four services told us that they
      provide information on these programs to these contacts, including
      the unit commander and other unit staff designated to provide this
      type of information to families. Two services—the Army and Marine
      Corps—created professional positions 35 within military units that are
      responsible for supporting family readiness by providing assistance to
      families, such as child care information. These positions also support
      formal volunteer organizations tasked with communicating information
      and providing education and support to military families. 36 Although



34
 GAO, Military Health: Increased TRICARE Eligibility for Reservists Presents Educational
Challenges, GAO-07-195 (Washington D.C.: Feb 12, 2007).
35
  Within the Marines this position is the Family Readiness Officer and within the Army it is
the Family Readiness Support Assistant.
36
    These volunteer organizations typically include military members and their spouses.




Page 20                                                       GAO-12-21 Military Child Care
    the Air Force and Navy have not designated such professionals within
    units, they have family services professionals outside of units who are
    assigned to serve servicemembers in units. For example, the Air
    Force has community readiness consultants and family child care
    coordinators assigned to serve specific units and provide the same
    type of support to families as do Army and Marine Corps unit-based
    professionals. Both Air Force and Navy also support similar volunteer
    organizations and efforts, such as Navy’s Family Ombudsman
    Program. Many servicemembers we spoke with stated that these
    family readiness professionals and volunteer organizations are helpful
    in learning about DOD-subsidized child care programs, while others
    noted that the level of assistance varies.

    Each of the four services has taken additional steps to increase
    outreach for these programs. For example, the Marine Corps
    prepared a fact sheet on DOD-subsidized off-installation child care
    programs, which includes answers to frequently asked questions
    including updated information on program policy changes. The Navy
    hired an outreach coordinator for installation and community-based
    child care programs. Also, the Army and Marine Corps provided
    resource and referral staff a “script” to ensure that staff members
    provide consistent, specific information on DOD-subsidized off-
    installation child care programs. The Air Force developed a marketing
    strategy including materials such as pamphlets and an
    implementation guide for program staff, intended to provide
    information on family child care programs to servicemembers.

•   Timing of information provided. Officials from DOD and groups
    representing military families told us that information on DOD-
    subsidized child care is more likely to be absorbed if it is provided
    when military families need it. Some servicemembers we spoke with
    mentioned that they ignored information on DOD-subsidized child
    care programs when they did not need child care, but were interested
    in such information when they later needed this service, such as when
    they became parents and had to return to work. One servicemember
    said briefings targeted to parents-to-be or those with children of
    similar ages would help overcome the problem of not getting
    information at the right time. For example, without targeted briefings
    about child care, not all parents-to-be learn about the need for getting
    on waiting lists for on-installation care. On one installation we visited,
    not all of the military mothers we spoke with had been advised that
    they needed to get on the CDC waiting list, which was about 9
    months, as soon as they learned they were pregnant. Those who



Page 21                                              GAO-12-21 Military Child Care
    were not alerted said that they had to take leave to care for their
    infants until they could find child care.

    Services recognize the need for targeted information on child care
    and have implemented education programs, such as those for
    expectant and new military parents, and mandatory physical training
    for postpartum servicemembers, both of which offer the opportunity to
    educate participants about the need to get on CDC wait lists. Services
    target child care information to military families in other ways, as well.
    For example, the Air Force offers a sponsorship program aimed at
    facilitating permanent change of station moves. Under this program,
    Air Force servicemembers trained as sponsors welcome and assist
    colleagues and their families who are new to an installation by
    providing information on local services, which can include information
    on DOD-subsidized child care options. One Air Force servicemember
    we spoke with had a sponsor that had helped her find housing and
    child care when she moved to a new installation. Other examples
    include the Navy and Air Force’s new programs to market DOD-
    subsidized child care programs to military families, such as to
    reservists who have children and have recently deployed.

•   Fewer opportunities off installation to educate servicemembers.
    DOD estimates that two-thirds of those stationed in the United States
    do not live on an installation and many of these families live long
    distances from an installation. However, because DOD child care
    programs have traditionally been focused on installations, more
    information about DOD-subsidized child care, including daily exposure
    to sources of child care information, is available to those living on or
    near an installation. For example, installation outreach can include a
    walk-in information and referral center and ongoing child care
    publicity, such as on marquees on the installation promoting child care
    programs. Also, military families that are geographically isolated from
    installations are likely isolated from military peers that DOD officials
    and several parents we spoke with cited as a source of child care
    information. As a result, families of servicemembers who do not live or
    work on an installation, such as recruiters and Guard and Reserve
    members, may be less aware of DOD-subsidized child care programs,
    including those that become available when they deploy. For
    example, results from a 2010 Army Guard survey showed that many
    Army Guard members were unaware of DOD-subsidized child care,
    while most military families living on or near an installation are likely
    knowledgeable about the availability of on-installation care.




Page 22                                              GAO-12-21 Military Child Care
    Limited exposure to on-installation information about DOD-subsidized
    child care may affect Guard and Reserve families to a greater extent
    than active duty families that live remote from an installation. These
    military families may often identify with the civilian, rather than the
    military world, and thus may be less likely to look to the military as a
    source of support. One reservist told us that reservists generally
    assume that if they do not live near a military installation, military
    services will not be available. Thus, many reservists might not even
    think to ask about DOD-subsidized child care when they are activated.

    DOD and NACCRRA have both taken steps to address the need to
    provide more opportunities to educate servicemembers about DOD-
    subsidized off-installation child care. DOD implemented the Joint
    Family Support Assistance Program to supplement and coordinate
    family services provided by the services, including child care, target
    military families geographically dispersed from a military installation,
    and collaborate with community organizations to enhance the
    availability of high-quality family services. 37 The services have also
    taken such steps. For example, the Air Force implemented an Air
    Force Reserve web page on the Family Members programs, which
    includes information on child care available to reservists. Marine
    Corps officials stated that in light of the subsidy cap they implemented
    in school year 2011 that will make subsidies available to more Marine
    Corps families, they have taken additional steps to contact reservists
    to educate them about off-installation program information, including
    program changes and how to obtain access to programs. In addition
    to hiring an outreach coordinator for installation and community-based
    child care programs, the Navy is developing marketing and
    communication strategies and webinar training specific to the Navy
    Reserves in order to better educate reservists about DOD-subsidized
    child care programs. The Army makes phone calls to families of
    deployed reservists to ask what services they need, including child
    care, and provides information and contacts for DOD-offered services.
    Also, because Reserve and Guard members may turn to civilian
    sources of assistance, NACCRRA officials stated that they asked their
    members to inform those who identify themselves as military families
    about DOD off-installation child care subsidy programs.


37
  DOD partnered with the University of Georgia to formally evaluate the Joint Family
Support Assistance Program in fiscal year 2011. OSD expects the evaluation to be
completed in November 2012.




Page 23                                                      GAO-12-21 Military Child Care
In addition to learning about DOD-subsidized child care, obtaining
information about applying for this care has also been a challenge
families face, because servicemembers must apply for on-installation
child care at different places than for off-installation child care. Also, for
off-installation programs there are a number of eligibility requirements for
the military family and standards for the community-based provider that
differ depending upon the program. Generally, in order to apply for on-
installation child care, including CDCs and Family Child Care, parents
must contact the on-installation child care resource and referral office.
However, if on-installation care programs have waiting lists and the family
needs child care immediately, they must contact another entity, generally
NACCRRA, if they choose to pursue DOD-subsidized off-installation care.
For the most part, this process is separate from the installation’s resource
and referral office and the installation generally does not follow up on
each family’s success in finding off-installation care. Although NACCRRA
assists families in finding an eligible community-based provider, if
available, and applying for DOD-subsidized care, some servicemembers’
spouses and Guard officials found applying for the programs difficult. For
example, several servicemembers’ spouses stated that the website did
not provide clear steps on how to apply for DOD-subsidized child care.
Further, several regional Guard officials stated that applying for off-
installation DOD-subsidized child care is complex because requirements
vary among programs, making it difficult to determine the programs for
which a military family may be eligible. Also, they noted that providers that
meet DOD’s requirements, which vary by program, are often not
available, especially for programs with more stringent standards and in
areas far from military installations. Additionally, several military parents
we spoke with said that because there is no one place to find child care
options available to them, particularly for off-installation child care, they
had to research these options themselves in order to find alternatives to
on-installation care.

DOD is developing a central system intended to enable eligible military
families worldwide, regardless of their service branch, to request military
Child and Youth Program services that meet individual child and family
needs. DOD officials told us that the system is aimed at helping educate
military families about DOD-subsidized child care by identifying programs
the family is eligible for based on information they enter into the system.
Such a system may help alleviate the problem of unclear information on
how to apply for programs and difficulties determining eligibility. DOD
intends to market the system DOD-wide to servicemembers once it is fully
implemented. The agency is in the process of contracting for the
development of a marketing plan which will include assessing marketing


Page 24                                             GAO-12-21 Military Child Care
                               needs and a strategy to market the system to users, in coordination with
                               the services, among other things. DOD plans to pilot the system in the
                               spring of 2012, and to begin full implementation of the system in the late
                               summer or fall of 2012.


Availability of On-            In response to limited availability of on-installation child care and eligible
Installation Care Is Limited   off-installation providers, DOD and the services are increasing capacity at
but Increasing, and            on-installation facilities and in the community as part of their commitment
                               to family readiness. According to DOD officials, the increased demand,
Eligible Off-Installation      due to high deployments and increased operational tempo, puts pressure
Providers Are Scarce           on the services, the Army and Marine Corps in particular. DOD officials
                               stated that CDC waiting lists are common and DOD officials told us that
                               Family Child Care home capacity is not increasing. As a result, many
                               military families may not be able to obtain on-installation care when they
                               need it. This is particularly an issue for families with children under the
                               age of 3, especially infants. To meet this demand, DOD is increasing on-
                               installation child care capacity by constructing new CDCs that it expects
                               will result in meeting 80 percent of the estimated demand for military child
                               care by 2012. DOD anticipates that construction projects approved in
                               fiscal years 2008 through 2010 will add over 21,000 additional child care
                               spaces.

                               Military families that cannot obtain on-installation care due to wait lists
                               and those that are geographically isolated from an installation may be
                               eligible for DOD-subsidized off-installation care, but community-based
                               providers who meet DOD’s quality standards are in short supply. Figure 3
                               shows the circumstances under which servicemembers may be eligible
                               for DOD-subsidized off-installation care.




                               Page 25                                              GAO-12-21 Military Child Care
Figure 3: Determining Eligibility for DOD-Subsidized Off-Installation Child Care




                                          Providers under Operation Military Child Care must be, at a minimum,
                                          licensed and annually inspected by their states, but according to
                                          NACCRRA not all states have requirements to regularly inspect licensed
                                          child care providers. Standards for providers under Military Child Care in
                                          Your Neighborhood are even more stringent. Under this program DOD
                                          requires eligible providers to be nationally accredited, but relatively few
                                          child care providers in the United States are accredited. According to a
                                          NACCRRA review, 38 in 2008 only about 10 percent of child care centers
                                          and 1 percent of family child care homes in the United States were
                                          nationally accredited. Additionally, the percent of child care centers with
                                          national accreditation varied from 2 to 47 percent among states.

                                          DOD is taking steps to increase the number of community-based
                                          providers eligible for DOD subsidies. In the near term, Army Child Care in
                                          Your Neighborhood and Army School-Age Programs in Your
                                          Neighborhood subsidize nonaccredited providers who are participating in
                                          an Army quality improvement program. To help increase providers


                                          38
                                            Linda K. Smith and Mousumi Sarkar, Making Quality Child Care Possible: Lessons
                                          Learned from NACCRRA’s Military Partnerships, NACCRRA (September 2008).
                                          According to the NACCRRA review, in 2008 only about 6 percent of family child care
                                          homes had a Child Development Associate-credentialed provider.




                                          Page 26                                                    GAO-12-21 Military Child Care
               participating in these and other off-installation programs the Army
               established a full-time position to coordinate and manage community-
               based child care at selected installations, such as Joint Base Lewis-
               McChord in Washington. 39 In addition, DOD is making more community-
               based providers available to military families who qualify for Military Child
               Care in Your Neighborhood by allowing the services to waive the
               accreditation requirement if it is determined that no accredited provider is
               available to the applicant. Further, according to NACCRRA it obtained
               agreements from all but three states to inspect licensed providers
               annually on a case-by-case basis so that military parents using these
               providers can receive subsidized care. Even with these efforts, DOD
               officials told us that some military families potentially eligible for DOD-
               subsidized child care assistance, including many who pay for child care,
               do not use subsidized care because they are not willing to switch to an
               eligible provider, or because they have no providers nearby who meet
               DOD’s standards. In the long term, DOD is piloting a 13-state initiative
               working with other federal agencies and state officials to increase the
               quality of child care programs by improving state-level child care
               oversight and licensing practices. The pilot’s intended purpose is to
               increase the number of providers who meet DOD quality standards. DOD
               selected these states, in part, because they have large military
               populations.


               The flexibility DOD has given the services to set their own child care fee
Concluding     policies, including subsidy caps for off-installation care, allows the
Observations   services to adjust fees and subsidy amounts to meet their budgetary
               needs and respond to local cost-of-living variations. However, this
               flexibility has also contributed to differences in the out-of-pocket costs
               paid by families with similar incomes, both among and within services.
               DOD’s efforts to reduce its on-installation fee ranges for families with
               similar incomes and its plan to require all services to charge one fee per
               income category in a few years may help provide increased financial
               consistency for families moving among installations. It is difficult to
               determine the degree to which policy changes, such as those related to
               subsidy caps, will affect costs for off-installation care for individual
               families, because these costs are driven to some extent by private
               provider fees, which vary considerably regardless of the services’



               39
                In the past, the Army had a contractor perform this work.




               Page 27                                                      GAO-12-21 Military Child Care
policies. However, it is likely that families in the three services with
subsidy caps will, on average, have higher costs than families in the
Army, which does not. Thus, DOD and the services face a policy trade-off
in determining the extent to which they will shoulder child care costs for
military families who cannot obtain on-installation care. For instance,
differences among the services in families’ costs for off-installation care
could be minimized if all services offered subsidies that made up the full
difference between a family’s private provider rate and what they would
have paid for on-installation care, with no subsidy caps. However, such a
policy change would require increased spending on child care for most of
the services, likely requiring them to divert budgetary resources from
other family programs to provide these higher subsidy amounts. In
addition, eliminating the caps could require greater oversight from the
services to ensure that providers did not raise their fee rates in response
to subsidy increases. On the other hand, some services use subsidy caps
to avoid having to limit the number of families who can benefit from
subsidies for off-installation care, so that all eligible families can have at
least some of their child care costs covered. As DOD and the services
move forward with their new fee policies, balancing these competing
priorities will be critical to supporting military families as they serve their
country, while also using resources carefully in an austere fiscal
environment.

DOD has taken some important steps to make military families aware of
DOD-subsidized child care programs, particularly off-installation
subsidies, and to make eligible child care available. Additional steps that
DOD is taking, such as waiving accreditation requirements and piloting a
13-state initiative designed to help states increase the quality of private
providers are important in helping families living off installation obtain
safe, reliable child care. As DOD increases the number of eligible child
care providers for off-installation programs and moves toward centralizing
access to DOD-subsidized child care programs through its planned
agencywide system for requesting both on- and off-installation care,
outreach will need to keep pace, with particular attention to families who
live off installation. DOD anticipates that its proposed marketing plan will
help better ensure that servicemembers are aware of this system once it
is fully implemented. Such a plan also provides an opportunity for
services to identify and share communication strategies with the most
potential. How well DOD executes both its marketing plan and
communication strategies will be crucial to ensuring that all families learn
about DOD-subsidized child care, including families that are
geographically isolated from installations and have few opportunities to
benefit from ongoing contact with installation resources, such as walk-in


Page 28                                              GAO-12-21 Military Child Care
                     information centers, on-installation child care publicity, and contact with
                     other military families who could tell them about military child care
                     options. Otherwise, the barriers families face in learning about and
                     accessing DOD-subsidized child care programs will likely persist.


                     We provided a copy of this draft report to DOD for comment and review.
Agency Comments      DOD provided written comments, which are reproduced in appendix IV of
and Our Evaluation   this report, and technical comments, which we incorporated as
                     appropriate. In its comments, DOD said that, in general, the report
                     correctly addresses the issues of providing fee assistance to military
                     members and assisting with access to child care. DOD also provided
                     clarification about the following issues: variations in on-installation child
                     care costs, fee caps, changes in policies to reduce out-of pocket costs,
                     and family support assistance. DOD also suggested caution in drawing
                     conclusions based on our random sample.

                     Regarding variations in per-child, on-installation child care costs, DOD
                     stated that in practice the fee variations are smaller than those we
                     reported due to the limited number of programs utilizing the high-cost fee
                     option. We believe that the report is very specific about not only the actual
                     fee ranges but also the percentage of installations that are charging these
                     fees. As stated in the report, we found that 64 percent of military
                     installations with CDCs charged fees within OSD’s standard fee range in
                     school year 2010, which means that over a third of the installations
                     charged fees within OSD’s high-cost range. The high-cost exceptions to
                     this were a few installations—a total of six and, again, specifically noted in
                     the report—that had very high cost-of-living allowances and charged fees
                     that were above OSD’s high-cost range. We recognize that in school year
                     2011 the number of military installations with CDCs that charged fees
                     within OSD’s high-cost range declined to about 11 percent and we noted
                     this in our final report in response to DOD’s comment.

                     DOD commented that eliminating the caps that three of the services have
                     placed on off-installation care fee assistance may not require increased
                     spending on child care for those services. DOD provided an Army
                     analysis that concludes that the average amount of child care fee
                     assistance the Army paid per child in recent fiscal years was less than the
                     capped rate currently paid by the other services. However, the Army’s
                     analysis does not take into consideration the effect of removing subsidy
                     caps for those services that have such caps. Based on our analysis, over
                     60 percent of Air Force and Navy families receiving subsidies for off-
                     installation care were affected by these services’ subsidy caps in school


                     Page 29                                             GAO-12-21 Military Child Care
year 2010. Thus, if the Air Force and Navy were to eliminate their subsidy
caps, they would incur paying higher subsidy amounts to over 60 percent
of families using this type of care, which would increase their total
spending on child care.

DOD stated that in addition to the recent and planned changes to DOD
and the Army’s fee policies that will likely reduce the differences among
the services, the Air Force also implemented fee policy changes reducing
out-of-pocket expenses for families. The Air Force change eliminates
additional fees if a child is in care more than 10 hours per day. However,
our analysis of the child care fees charged by the services did not include
any additional fees they may have charged beyond the base fees for
regularly scheduled care, such as fees for care beyond 10 hours per day.
Thus, eliminating those additional fees would not change the fee
differences among the services that we include in this report.

DOD also commented that in regard to the family support assistance
provided by professional positions, it believes that the Air Force and Navy
provide the same level of service as the Army and Marine Corps, but in a
different manner. We did not assess the level of family support assistance
provided by each service. Instead, we reported the various ways these
services provide such assistance through professionals within and
outside the units and through the services’ support of volunteer
organizations. That said, we recognize the importance of the Navy’s
Family Ombudsman Program and have added it as an example of a
volunteer effort in the report.

In addition to these clarifications, DOD also commented that the GAO
random probability sample of 338 families relative to the total number of
families accessing the system of care indicates the need for caution in
drawing conclusions about accessibility of information and child care
options. We agree that this sample does not represent the total number of
families accessing DOD’s child care system. The sample’s analysis,
which is outlined in appendix I, provides findings related to families’ off-
installation child care costs at the family and child level, in conjunction
with other variables such as family income, private provider fees, and the
estimated fee the family would have paid for on-installation care.




Page 30                                            GAO-12-21 Military Child Care
We are sending copies of this report to the Secretary of Defense,
appropriate congressional committees, and other interested parties. The
report also is available at no charge on the GAO website at
http://www.gao.gov.

If you or your staff members have any questions about this report, please
contact me at (202) 512-7215 or brownke@gao.gov. Contact points for
our Offices of Congressional Relations and Public Affairs may be found
on the last page of this report. GAO staff members who made key
contributions to this report are listed in appendix V.




Kay E. Brown
Director, Education, Workforce,
  and Income Security Issues




Page 31                                           GAO-12-21 Military Child Care
Appendix I: Objectives, Scope, and
                         Appendix I: Objectives, Scope, and
                         Methodology



Methodology

Objectives               Our review focused on the following questions: (1) What are the out-of-
                         pocket child care costs paid by military families who use Department of
                         Defense (DOD) subsidized child care? (2) What are the barriers, if any, to
                         obtaining DOD-subsidized care, and what has DOD done in response?


Sample of Family Files   To determine the out-of-pocket costs for families using DOD-subsidized
                         off-installation care, we analyzed these costs for a random probability
                         sample of 338 families from all four services in school year 2010. 1, 2
                         Specifically, we collected and analyzed data from family files maintained
                         by the contractor that administers DOD’s off-installation child care
                         subsidies, the National Association of Child Care Resource and Referral
                         Agencies (NACCRRA). Our sample included families that participated in
                         regularly scheduled child care through Operation Military Child Care and
                         Military Child Care in Your Neighborhood, the two DOD-wide subsidy
                         programs for off-installation care, as well as smaller service-specific
                         programs: Army Child Care in Your Neighborhood, Army School-Age
                         Program in Your Neighborhood, the Army’s Warriors in Transition
                         program, and the Marine Corps’ San Diego Quality Improvement
                         Program. This analysis allowed us to generalize our findings to all families
                         receiving DOD subsidies for off-installation child care in school year 2010.

                         NACCRRA maintains an electronic database with information that
                         allowed us to identify all the military families it served in school year 2010.
                         We used this database to generate our sampling frame of families.
                         However, since this database does not include the information needed to
                         calculate families’ out-of-pocket costs, we collected our data variables
                         from the information contained in paper files NACCRRA maintains for
                         each family. To create our sampling frame, NACCRRA used the database
                         to generate a list of all families and children who received DOD subsidies
                         for off-installation care in school year 2010. In selecting our sample, we



                         1
                          Our sample included active duty servicemembers and members of the National Guard
                         and Reserves.
                         2
                          According to DOD officials, the school year may begin in August or September,
                         depending on the local school schedule. However, DOD normally requires that child care
                         policies for the new school year be implemented no later than September 30. For the
                         purposes of our sample, we used fiscal year 2010 (October 1, 2009 through September
                         30, 2010) as a proxy for school year 2010. Because we conducted our sample data
                         collection in the spring of 2011, school year 2010 was the most recent school year for
                         which we could collect a full school year of data.




                         Page 32                                                    GAO-12-21 Military Child Care
                Appendix I: Objectives, Scope, and
                Methodology




                stratified families by service (Air Force, Army, Marine Corps, and Navy)
                and either Active Duty or National Guard and Reserves (combined group)
                component. No prior data existed on the out-of-pocket child care costs of
                military families receiving subsidies that would allow us to calculate the
                variance in these costs, which we needed to determine our sample size.
                Thus, we collected a presample of 157 files (at least 36 from each
                service), calculated the out-of-pocket costs for those families, and then
                calculated the variance in costs for each service. We used the variance to
                determine the number of family files we would need to collect for the final
                sample in order to calculate the margin of error for each stratum to be no
                more than plus or minus $90.

                To obtain the family files for both the presample and the final sample, we
                provided NACCRRA with the family identification numbers for the files we
                had randomly selected. When NACCRRA staff had pulled the paper files
                for these families, we went to their offices in person to verify the files they
                had pulled. NACCRRA staff then scanned the documentation we needed
                and sent it to us in PDF form. We requested only documentation
                pertaining to school year 2010 (October 1, 2009 through September 30,
                2010). We requested and received the following documentation from
                each file:

                •   Each child’s schedule of care,

                •   all provider rate sheets,

                •   all fee calculator(s) used to calculate the subsidy rate, and

                •   servicemember’s deployment orders, if applicable.

                Using this documentation, we input data for each family and child in Excel
                spreadsheets. We ensured the reliability of these hand-entered data by
                having two analysts enter all data, then reconciling any discrepancies
                between the two data spreadsheets.


Data Analysis   For the first objective, to determine the out-of-pocket costs for families
                using on-installation care, we obtained data from DOD and the services
                on the range of fees charged per child at installations in school years
                2010 and 2011. Family-level cost data for on-installation care were not
                available. Our analysis on families’ out-of-pocket costs is limited to their
                weekly or monthly child care fees, although families may pay additional
                costs, such as fees for special events and activities. In addition, our


                Page 33                                               GAO-12-21 Military Child Care
Appendix I: Objectives, Scope, and
Methodology




analysis of these fee data focused on school year 2010, so that we could
present data on costs for on-installation care that covered the same time
period as our data on off-installation care costs. We also analyzed
changes to the on-installation fee ranges in school year 2011. DOD and
three of the four services provided data on weekly fees, while the fourth
service (Army) provided monthly fees. We converted DOD and the other
services’ weekly fees to monthly fees using the same calculation used by
the Army to obtain monthly fees. Specifically, we multiplied the weekly
fees by 365/7 (the number of weeks in a year) to get the yearly fee
amount, and then divided by 12 to obtain the monthly fee amount. This
calculation assumes a 365-day year, as well as an equal number of days
in each month. Since months vary slightly in length, the monthly amount
paid by families in services that charge fees on a weekly basis will also
vary slightly. In addition, all Army installations allow families 2 weeks of
vacation per year, during which they do not pay child care fees if their
children are not in care. Army families’ monthly fees are calculated such
that families pay more during the other 50 weeks of the year to make up
for the 2 weeks of vacation. We recalculated Army fees without this
vacation credit to make them comparable to other services’ fees, which
are generally not reported in this form.

To determine families’ costs for off-installation care, we collected data
from a sample of 338 NACCRRA family files, as described above. We
analyzed these data to determine families’ off-installation child care costs
at the family and child level, in conjunction with other variables such as
family income, private provider fees, and the estimated fee the family
would have paid for on-installation care. We compared the averages of
these variables across services. In this analysis, we weighted family and
child data based on the family’s probability of being selected for the
sample, which varied due to differences in the population size of each
stratum (e.g., families of active duty Army servicemembers). Because we
followed a probability procedure based on random selections, our sample
was only one of a large number of samples that we might have drawn.
Since each sample could have provided different estimates, we express
our confidence in the precision of our particular sample’s results as a 95
percent confidence interval (e.g., plus or minus $100). This is the interval
that would contain the actual population value for 95 percent of the
samples we could have drawn.

For this objective, we also reviewed the child care fee policies set by
DOD and the services for school years 2010 and 2011, including the fees
charged to families for on-installation care, any discounts offered to
families, and how subsidies are calculated for off-installation care. Some


Page 34                                             GAO-12-21 Military Child Care
                   Appendix I: Objectives, Scope, and
                   Methodology




                   aspects of the services’ fee policies, such as their methods of calculating
                   subsidies for off-installation care, were not contained in written policies.
                   We obtained this information through interviews with DOD and service
                   officials. We also interviewed these officials regarding the implementation
                   of these policies.


Data Reliability   Because external data were significant to our research objectives, we
                   assessed the reliability of the data obtained from DOD and NACCRRA. To
                   assess the reliability of the data on the range of fees charged by each
                   service in school years 2010 and 2011, we interviewed officials from each
                   service on their annual process for collecting and reviewing data on the
                   fees charged by their installations. 3 To assess the reliability of the
                   NACCRRA data that we used as the sampling frame for our sample of
                   families using off-installation care, we interviewed NACCRRA officials
                   about their database and how they maintain it. To assess the reliability of
                   the Defense Manpower Data Center data that we used to determine the
                   number of servicemembers and their children who were eligible for DOD
                   child care assistance in fiscal year 2011, we interviewed Defense
                   Manpower Data Center officials about the reliability of the relevant data
                   fields and also conducted electronic testing of the data. We found the data
                   we assessed to be sufficiently reliable for the purposes of reporting the
                   range of on-installation fees per child by service in school years 2010 and
                   2011, and out-of-pocket costs for families using DOD-subsidized off-
                   installation child care in school year 2010. We found that the Defense
                   Manpower Data Center data may not capture 100 percent of the children of
                   servicemembers who are eligible for child care, because Guard and
                   Reserve members are not required to report their children in the data
                   system that populates the Defense Manpower Data Center data fields on
                   servicemembers’ children. In addition, we found that, because the Defense
                   Manpower Data Center data we received included members of all reserve
                   categories, these data included some servicemembers and children who
                   were not eligible for child care. We determined that these limitations were
                   minor enough to allow us to report the approximate number of
                   servicemembers eligible for DOD child care in the background of the report.



                   3
                    Because Navy fee policy requires that all standard cost installations charge one fee for
                   each income category and all high-cost installations charge a different set of fees for each
                   income category, we reported the standard- and high-cost fees set in Navy fee policy, and
                   did not need to assess the reliability of these fee data.




                   Page 35                                                       GAO-12-21 Military Child Care
                               Appendix I: Objectives, Scope, and
                               Methodology




Installation Site Visits and   To address the second objective, we reviewed relevant federal laws,
Structured Discussion          policies and guidance, studies and surveys of military parents, and
Groups                         interviewed child and youth program officials with DOD and each of the
                               four services, including officials at service headquarters and installations.
                               We also interviewed representatives of NACCRRA, nonprofit
                               organizations that support military families, and researchers
                               knowledgeable about DOD child care programs. In addition, we visited
                               two large military installations (Joint Base Lewis-McChord, Wash.—
                               Army/Air Force), and Marine Corps Base Camp Lejeune, N.C.) and
                               conducted phone interviews with officials at two additional large military
                               installations (Naval Station Norfolk, Va., and Nellis Air Force Base, Nev.)
                               to learn how each implements child care programs and discuss barriers
                               faced by families in obtaining access to these programs. To obtain
                               examples of child care programs and barriers faced by military parents at
                               installations with no on-installation child care facilities, we also conducted
                               telephone interviews with officials at two small installations affiliated with
                               two services (Army’s Yakima Training Center, Wash., and Creech Air
                               Force Base, Nev.), for a total of four phone interviews with installations.
                               For our site visits, we selected large installations that had a Guard and/or
                               Reserve presence and had significant deployment activity. Visiting two
                               large installations—one each representing the Army and Marines––
                               provided examples of a large and a small service’s approaches to child
                               care programs. We also selected one installation that is a joint base—
                               having two military services on base—the Army, the lead service, and the
                               Air Force.

                               During our site visits we also conducted six semi-structured discussion
                               groups with military parents at Joint Base Lewis-McChord, and five at
                               Marine Corps Base Camp Lejeune, including parents who did and who
                               did not have their children enrolled in DOD-subsidized child care. We also
                               held two additional semi-structured discussions with reserve
                               servicemembers at Camp Lejeune. During these semi-structured
                               discussions we inquired into how parents learned about DOD-subsidized
                               child care and any barriers they may have encountered obtaining this
                               care. In addition, we conducted phone interviews with child care officials
                               and military parents at two additional large military installations—Naval
                               Station Norfolk, Va., and Nellis Air Force Base, Nev. The information
                               obtained during these visits and through phone calls is illustrative and not
                               representative of each service or of DOD programs as a whole.

                               In order to select servicemembers for our small discussion groups at the
                               two sites we visited, we provided DOD with selection criteria that they
                               used to identify servicemembers to invite to these groups. Because we


                               Page 36                                              GAO-12-21 Military Child Care
                    Appendix I: Objectives, Scope, and
                    Methodology




                    held separate discussions with officers and enlisted servicemembers, we
                    used the same criteria for each. Our criteria were officers and enlisted
                    servicemembers with children 12 and under who were using DOD child
                    care—including both on-installation facilities and off-installation
                    community care subsidies—and those not using such care. In addition, at
                    each site we visited we also met with a small group of spouses of
                    servicemembers with children 12 and under. Many of these spouses
                    worked for a DOD family support office or were members of military
                    organizations that serve spouses, such as the Marine Corps L.I.N.K.S
                    program, which is a volunteer, mentoring program, designed by Marine
                    Corps spouses to help family members understand and adapt to the
                    unique challenges of military life.


Review of NACCRRA   To assess the methodological quality of a NACCRRA study we used to
Studies             support the scarcity of providers eligible to receive DOD child care
                    subsidies, 4 we reviewed the study’s methodology and also obtained
                    responses from NACCRRA to questions we had about this methodology.
                    We used a different NACCRRA study to identify differences in how states
                    oversee and regulate private child care providers. 5 Since this study did
                    not include a methodology, we obtained information from NACCRRA
                    about the methodology it used to prepare this report. We also confirmed
                    certain information NACCRRA included in the study for the two states
                    where we performed site visits at installations in order to help verify the
                    accuracy of this information and found no relevant discrepancies between
                    the study and state-provided information. We found these reports to be
                    sufficiently reliable for the purposes described above.




                    4
                     Linda K. Smith and Mousumi Sarkar, Making Quality Child Care Possible: Lessons
                    Learned from NACCRRA’s Military Partnerships, NACCRRA (September 2008).
                    5
                    Unpublished NACCRRA study done at the request of DOD.




                    Page 37                                                  GAO-12-21 Military Child Care
Appendix II: On-Installation Fee Ranges in
                                        Appendix II: On-Installation Fee Ranges in
                                        School Year 2011



School Year 2011

Figure 4: Office of the Secretary of Defense (OSD) Allowable Monthly Fee Ranges and Ranges in the Actual Fees Charged by
Services for On-Installation Care in School Year 2011, by Income Category




                                        Page 38                                                GAO-12-21 Military Child Care
Appendix II: On-Installation Fee Ranges in
School Year 2011




Note: Fees are for full-time child care at Child Development Centers (CDC), and do not include any
fee reductions that individual families may receive. OSD fee policy sets ranges for weekly fees, and
all of the services except the Army set and charge fees on a weekly basis. Fee ranges have been
converted to monthly terms using calculations that assume a 365-day year and an equal number of
days per month. Families’ actual monthly costs will vary slightly depending on the length of the
month. In addition, all Army installations allow families 2 weeks of vacation per year, during which
they do not pay child care fees if their children are not in care. Army families’ monthly fees are
calculated such that families pay more during the other weeks of the year to make up for the 2 weeks
of vacation. We recalculated Army fees without this vacation credit to make them comparable to other
services’ fees, which are generally not reported in this form. The Army also obtained permission from
OSD to allow some of its installations that had been charging rates at the lower end of the previous
fee ranges to charge rates below the new fee ranges in school year 2011, to prevent families at these
installations from experiencing large fee increases. Additionally, Army officials said that OSD officials
granted permission for nearly all Army installations to charge fees below the OSD standard range for
Categories VII through IX. Consequently, the lower end of the range of fees actually charged by the
Army is lower than the minimum OSD fee for all but one fee category. Three Army installations—Fort
Monroe, Fort Monmouth, and Fort McPherson—were in the process of closing due to Base
Realignment and Closure in school year 2011, and were therefore not required to adopt the new
school year 2011 fee policy. As a result, we did not include these installations in our fee range
calculations. Due to rounding, in a few instances the services’ fee ranges may appear slightly lower or
higher than the OSD fee ranges.




Page 39                                                                GAO-12-21 Military Child Care
Appendix III: Supplemental Data from
              Appendix III: Supplemental Data from Sample
              of Families Using DOD-Subsidized Off-
              Installation Care


Sample of Families Using DOD-Subsidized
Off-Installation Care
              Table 6: Number of Families and Children in Sample, by Service and Component

                  Service/component                            Number of families            Number of children
                  Total                                                           338                          499
                  Air Force                                                           95                       147
                    Active Duty                                                       50                        66
                    National Guard and Reserve                                        45                        81
                  Army                                                                83                       121
                    Active Duty                                                       29                        42
                    National Guard and Reserve                                        54                        79
                  Marines Corps                                                       60                        88
                    Active Duty                                                       35                        50
                    Reserve                                                           25                        38
                  Navy                                                            100                          143
                    Active Duty                                                       52                        67
                    Reserve                                                           48                        76
              Source: GAO analysis of data from NACCRRA.




              Table 7: Average, 10th Percentile, and 90th Percentile Annual Total Family Incomes
              of Families Using Off-Installation Care in Fiscal Year 2010, by Service

                  Service            Average incomea 10th percentile incomeb 90th percentile incomec
                  All services                     $84,860                    $47,539                      $130,497
                  Air Force                        100,615                     48,350                       174,476
                  Army                               85,485                    48,659                       130,559
                  Marine Corps                       77,627                    42,747                       117,538
                  Navy                               77,319                    46,548                        99,109
              Source: GAO analysis of data from NACCRRA.
              a                                                                   $
                  95% margins of sampling error for these estimates range from +/- 5,197 to +/- $14,928.
              b
                  95% confidence intervals for these estimates do not exceed $33,155 to $59,947.
              c
                  95% confidence intervals for these estimates do not exceed $93,432 to $183,538.




              Page 40                                                                 GAO-12-21 Military Child Care
Appendix III: Supplemental Data from Sample
of Families Using DOD-Subsidized Off-
Installation Care




Table 8: Percent of Families Using Off-Installation Care with a Servicemember Who
Was Deployed in Fiscal Year 2010, by Service

    Service                                                                      Percent deployed
    All services                                                                                 26
    Air Force                                                                                    15
    Army                                                                                         30
    Marine Corps                                                                                 16
    Navy                                                                                         19
Source: GAO analysis of data from NACCRRA.

Note: 95% margins of sampling error for these estimates range from +/- 6% to +/- 11%.



Table 9: Average Monthly Costs per Child for Off-Installation Care in School Year
2010, by Service

                                                      Average difference       Average cost for off-
                                                    between cost for off-      installation care as a
                                                    installation care and              percentage of
                           Average cost for                estimated on-               estimated on-
    Service            off-installation carea            installation feeb          installation feec
    All                                      $387                    -$27                     91.5%
    Air Force                                 542                      33                      107.7
    Army                                      345                      -43                      87.1
    Marine Corps                              388                      -42                      88.6
    Navy                                      562                      66                      113.9
Source: GAO analysis of data from NACCRRA.
a
    95% margins of sampling error for these estimates do not exceed +/- $48.
b
    95% margins of sampling error for these estimates do not exceed +/- $42.
c
    95% margins of sampling error for these estimates range from +/- 5.7% to +/- 10.5%.



Table 10: Percent of Air Force and Navy Families Using Off-Installation Care
Affected by Subsidy Cap in School Year 2010

    Service                                                                        Percent capped
    Air Force                                                                                    66
    Navy                                                                                         63
Source: GAO analysis of data from NACCRRA.

Note: 95% margins of sampling error for these estimates do not exceed +/- 12%.




Page 41                                                               GAO-12-21 Military Child Care
Appendix IV: Comments from the
                     Appendix IV: Comments from the Department
                     of Defense



Department of Defense

Note: GAO received
DOD’s letter on
January 6, 2012.




                     Page 42                                     GAO-12-21 Military Child Care
Appendix IV: Comments from the Department
of Defense




Page 43                                     GAO-12-21 Military Child Care
Appendix V: GAO Contact and Staff
                  Appendix V: GAO Contact and Staff
                  Acknowledgments



Acknowledgments

                  Kay E. Brown, (202) 512-7215 or brownke@gao.gov
GAO Contact
                  Janet Mascia, Assistant Director, and Julianne Hartman Cutts, Analyst-in-
Acknowledgments   Charge, managed this assignment. Caitlin Croake, Lauren Gilbertson,
                  Hayley Landes, and Suzanne Rubins made significant contributions to all
                  aspects of this report. Kate Van Gelder, Holly Dye, and James Bennett
                  provided writing and graphics assistance. In addition, Kirsten Lauber,
                  Terry Richardson, Jeff M. Tessin, and Cynthia Grant provided design and
                  methodological assistance. James Rebbe provided legal assistance.




(131003)
                  Page 44                                          GAO-12-21 Military Child Care
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