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How might we assess immediate AND longer-term childcare needs among UNC Health Care workers ASAP?

HMW: How might we assess immediate AND longer-term childcare needs among UNC Health Care workers ASAP?

What we learned:

In our meetings today, we met with Orange County officials and state officials (Governor’s Office, NC DHHS (including DCDEE) and NC DPI) and heard of several innovative, fast efforts on-the-ground to provide emergency care for school-aged children. Orange County set up an emergency program for its essential employees at the SportsPlex in Hillsborough. However, the emergency site only cared for one child yesterday and no children today. Our contact at NC DPI mentioned that a YMCA in the western part of our state rushed to set up emergency care for school-aged children as well, but only two children showed up.

This sparks the following questions:

  • What is the actual need of care needs for school-aged children right now? [Things we’re asking ourselves: Have we missed the mark entirely? What if we are setting up all these centers but the childcare issue is solvable short- and long-term through informal channels (e.g. medical students volunteering to babysit)? Could the time and money be spent on solving this problem be dedicated elsewhere?]

  • If essential workers have found childcare solutions for the immediate future, will these solutions sustain in the coming weeks/months? [Perhaps essential workers have figured out childcare for the next few weeks so are not opting-in to these emergency care sites yet. How will we be able to assess immediate and longer-term needs to determine whether we will need these emergency sites to stay open or whether we need more emergency sites?]

  • How is news about the opening of these emergency care centers being disseminated to essential employees? [Perhaps there is a need for emergency care for school-aged children but better communication channels or messaging is needed.]

  • What are essential employees’ concerns about bringing their children to these emergency sites? [What if there is a need for emergency care for school-aged children and strong communication efforts BUT essential employees are still not comfortable bringing their children to these emergency sites? What are their worries and barriers?]

NC DHHS is working to continuously update guidance and recommendations for childcare sites and for the emergency care sites for school-aged children now that we’ve explicitly gone from a containment approach to a mitigation one. They will take into consideration the recommendations that our Task Force put together with advisor Dr. Allison Aiello to improve the safety of our emergency sites.

Some of these recommendations included:

  • Smaller groups sizes (the 1:25 ratio for care providers to school-aged children is too big even though it complies with CDC guidelines)

  • Children should be assigned to the same care provider every day (for consistency during what may be a scary and stressful time for them and to minimize contact with lots of different children and care providers)

  • Children in the same family should be clustered together (instead of spreading them out across different care providers and having them interact with different groups of children since we know that COVID-19 clusters tend to be within families); and

  • Cluster children whose parents have similar exposure levels to COVID-19 together.


  • We (and UNC Health Care and state entities) really need to continue using a human-centered approach to iteratively ask and answer questions like the four outlined above. We need to be naming and testing assumptions before we commit and pay (especially at a large-scale) for solutions.

  • UNC Health Care is still not sure whether they want to send out a Qualtrics survey to their employees through Human Resources (HR) to assess childcare needs. Some of their concerns are:

  • They worry about overburdening their employees. One HR rep asked, “If [employees] don’t have time to pee, is it insensitive to ask them to fill out a survey?”Some shared that there may also be some skepticism from employees: “What are they going to do with all these data?”

  • While Task Force members continue to advocate for the need for a survey to assess 1) actual immediate and longer-term needs for childcare; 2) employees’ ability to pay for childcare; and 3) employees’ preferences for different kinds of childcare solutions, we will continue to gather data through conversations with UNC Health Care employees, childcare providers (0-5), organizations who can offer emergency care for school-aged children, and school district leaders.

Questions generated:

  • How many superintendents will opt-in to opening their schools for emergency care sits for school-aged children?

  • We’ve heard that other healthcare systems and specific sites within UNC Heath Care are already working with their local school districts to figure out emergency care for school-aged children.

  • Is UNC Health Care actively contacting the public school districts to advocate for partnership?

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