Jenny Gold and Kate Sequeira | Los Angeles Times (TNS)

The vice presidential candidates appeared to find some agreement during their Tuesday night debate over child care and paid family leave, in the longest and most in-depth campaign exchange about these issues to date.

In California and throughout the nation, these issues are key to improving quality of life for families that struggle to take time off to care for a newborn or ailing loved one, or to find affordable child care. Despite California’s significant investments in these areas, solutions still fall short of meeting the needs of many parents.

Republicans in Congress opposed President Biden’s ambitious 2021 plan to create an affordable child care system and a universal paid family leave benefit. Yet Sen. JD Vance — former President Donald Trump’s running mate — appeared to offer some support for both issues during the debate, voicing more moderate stances than he has in recent appearances.

“I think there is a bipartisan solution here because a lot of us care about this issue,” Vance said in response to a question from CBS News’ Margaret Brennan about a national paid leave program. As for the child care crisis, Vance agreed with Minnesota Gov. Tim Walz — Vice President Kamala Harris’ running mate — that the government needs to spend more money.

“We’re going to have to induce more people to want to provide child care options for American families because the reason it’s so expensive right now is because you’ve got way too few people providing this very essential service,” he said.

But this diagnosis of the child care market as a simple supply-side problem conflicts with how child care experts see it.

“It reveals a fundamental misunderstanding of the child care problem because it’s a broken market,” said Kathryn Anne Edwards, a labor economist and policy consultant who studies the child care market.

Meanwhile, Vance’s solution — that the problem can be solved by offering families more choice of who can provide care for their children — is something the government already does. And under the current system, low-income families can use subsidies provided by the government to pay for the child care of their choice, including faith-based providers and care provided by a relative or friend.

Why is child care so expensive in the U.S.?

Child care is often described as a “broken market” for good reason: Child care employees are some of the lowest-paid workers in the economy, at an average of $13.22 an hour, yet despite these low wages, the price of care is astronomical for families.

In California, for example, placing an infant in a private child care center cost an average of $19,547 per year in 2021, according to the nonprofit Child Care Aware. That’s 15% of the median income for a married couple in the state, and 47.6% of the median income for a single parent.

There are shortages of care in many places, including Los Angeles. But while Vance’s suggestion to expand supply might help more families find care, it is unlikely to significantly bring down costs.

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That’s because the biggest problem is that child care costs more to provide than families can afford to pay. There aren’t many opportunities to trim costs, because the job of a child care worker can’t be automated and employers can’t pay them any less. Workers are already fleeing the profession in search of higher wages in retail or fast food.

Meanwhile, Edwards says, there isn’t a line of people waiting to open child care centers, because it’s not a profitable business.

Walz was not asked directly about child care, but addressed it in a question about paid family leave in somewhat vague terms, saying that child care workers needed higher wages, and families more support to pay for care.

“You can’t expect the most important people in our lives to take care of our children or our parents to get paid the least amount of money,” he said. “And we have to make it easier for folks to be able to get into that business and then to make sure that folks are able to pay for that.”

In the Democratic plan, this would mean the federal government subsidizing care for more families.

Moving the child care system from a “profit model” to a “reimbursement model,” in which the government pays child care workers what it costs for them to provide the care is “the only solution for child care,” Edwards said. “Workers are not going to get cheaper, care is not going to get cheaper, and more people aren’t going to enter the market.”

What can families spend their child care assistance on?

The government already provides subsidies to low-income families to help cover child care costs; families can also attend free government-funded programs including Head Start and state preschools. Seventeen percent of children younger than 5 in California are served by government-subsidized child care programs.

The federal government helps fund subsidies for families earning a maximum of 85% of their state’s median income — $104,544 for a family of four in California — through the Child Care and Development Block Grant, though many states cap it far lower.

During the debate, Vance said these subsidies fund only “one kind of child care model. Let’s say you’d like your church, maybe, to help you out with child care. Maybe you live in a rural area or an urban area, and you’d like to get together with families in your neighborhood to provide child care in the way that makes the most sense. You don’t get access to any of these federal monies.”

This is false.

The government allows subsidies from the block grant program — in the form of vouchers to families — to be used for a variety of options — including both churches and care provided by a family member, friend or neighbor.

The block grant was created as a “pro-choice federal program” by Republican President George H.W. Bush in 1990, said Bruce Fuller, a UC Berkeley professor of education and public policy. “The idea that the government disincentivizes using grandma is just incorrect.”

The problem is that the available vouchers are not nearly enough to meet the need. Of the nearly 6.3 million children ages 5 and younger in the U.S. whose families qualify for these subsidies, fewer than 840,000 receive it, or about 13%. There are often long lists of families waiting for a voucher to become available, including in California.

Meanwhile, families in the middle class are generally left paying sticker price.

What do Democrats propose as a child care solution?

In September during an interview with members of the National Association of Black Journalists, Harris announced a child care plan proposing that working families would not pay more than 7% of their income for child care.

The 7% cap idea isn’t new. It was proposed in 2021 in Biden’s Build Back Better bill, which Congress failed to pass.

The plan would have established a universal preschool program and capped a family’s child care spending at 7% of income for anyone earning up to 250% of state median income. In California, that’s more than $277,000 for a family of four. Families earning more would have continued to pay full price. The overhaul would have cost an estimated $380 billion over six years.

Meanwhile, a separate proposal mentioned in the 2024 Democratic Party platform would instead cap family costs at $10 a day.

What do Republicans propose as a solution for child care?

Trump has not yet offered details for improving the child care system, and the GOP campaign platform does not mention the issue.

“Child care is child care, it’s something you have to have in this country. You have to have it,” Trump told business leaders at the Economic Club of New York. His proposed tax on imports from foreign nations at higher levels, he said, would “take care” of such problems.

Vance supported this plan during the vice presidential debate. “I think what President Trump is saying is that when we bring in this additional revenue with higher economic growth, we’re going to be able to provide paid family leave, child care options that are viable and workable for a lot of American families.

Why doesn’t the U.S. have national paid family leave?

The U.S. is one of only a few countries that does not guarantee paid leave nationally. Only Washington, D.C., and 13 states — including California — have passed such legislation. But the issue has bipartisan support from voters, according to Laura Narefsky, senior counsel for education and workplace justice at the National Women’s Law Center.

“This is not a polarizing issue for the American people, because at some point everyone has had to give or provide care,” Narefsky said.

Walz, who called paid family leave a “Day One” issue at the debate, touts a program he signed into law in Minnesota that will provide up to 20 weeks in a year for family and medical leave. The program, which will go into effect in 2026, will be funded by a payroll tax shared between workers and employers.

Vance did not say whether there should be a national law but agreed that paid family leave is a “bipartisan issue,” saying that his wife, an attorney, benefited from such a policy from her employer.

Currently, the federal government guarantees up to 12 weeks of unpaid but job-protected family and medical leave for eligible employees. In 2019, Trump also signed into law up to 12 weeks of paid parental leave for qualifying federal employees.

A national paid leave law has been shot down multiple times over the last several decades. An iteration of it made it into the failed Build Back Better bill before getting slashed.

And though Trump was the first Republican president to call for paid family leave, proposed programs during his administration did not receive bipartisan support in part because of their approaches to funding, which required families to borrow against their future selves.

A bill to provide 12 weeks of paid leave was reintroduced to Congress in May 2023.

How does paid family leave work in California?

California is home to the oldest paid family leave program in the country, which it has continued to tweak since its passage in 2002. Starting in January, the state is increasing how much a worker can collect while on family or medical leave as part of an effort to ensure low-wage workers can afford to take it.

Those who earn up to $60,000 a year will be able to get 90% of their income replaced while on family or medical leave in California, up from 60%. Workers who earn more will be able to collect 70%.

To help make up for the increase, California is removing the ceiling on the payroll tax, requiring higher-income earners to contribute the same 1.1% of their earnings as everyone else rather than capping the tax when their wages reach $153,164.

Though most states with paid leave offer up to 12 weeks, California lags behind. The state expanded paid family leave from six to eight weeks in 2020. Despite that, California does have one of the lowest barriers to entry, according to Jenya Cassidy, director of the California Work & Family Coalition. Anyone who earns at least $300 in a year and contributes to state disability insurance is eligible for the benefits.

This article is part of The Times’ early childhood education initiative, focusing on the learning and development of California children from birth to age 5. For more information about the initiative and its philanthropic funders, go to latimes.com/earlyed.

©2024 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.

By Tony Leys | KFF Health News

ADAIR, Iowa — The blue-and-white highway sign for the eastbound rest stop near here displays more than the standard icon of a person in a wheelchair, indicating facilities are accessible to people who can’t walk. The sign also shows a person standing behind a horizontal rectangle, preparing to perform a task.

The second icon signals that this rest area along Interstate 80 in western Iowa has a bathroom equipped with a full-size changing table, making it an oasis for adults and older children who use diapers because of disabilities.

“It’s a beacon of hope,” said Nancy Baker Curtis, whose 9-year-old son, Charlie, has a disability that can leave him incontinent. “I’m like, ‘Oh my gosh, we’re finally there.’”

The white changing table is 6 feet long and can be lowered and raised with a handheld controller wired to an electric motor. When not in use, the table folds up against the wall.

The table was recently installed as part of a national effort to make public bathrooms more accessible in places like airports, parks, arenas, and gas stations. Without such options, people with disabilities often wind up being changed on bathroom floors, in cars, or even on the ground outside.

Many families hesitate to go out because of the lack of accessible restrooms. “We all know somebody who’s tethered to their home by bathroom needs,” Baker Curtis said. She doesn’t want her son’s life to be limited that way. “Charlie deserves to be out in the community.”

She said the need can be particularly acute when people are traveling in rural areas, where bathroom options are sparse.

Baker Curtis, who lives near Des Moines, leads the Iowa chapter of a national group called “Changing Spaces,” which advocates for adult-size changing tables. The group offers an online map showing scores of locations where they’ve been installed.

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Advocates say such tables are not explicitly required by the federal Americans with Disabilities Act. But a new federal law will mandate them in many airports in coming years, and states can adopt building codes that call for them. California, for example, requires them in new or renovated auditoriums, arenas, amusement parks, and similar facilities with capacities of at least 2,500 people. Ohio requires them in some settings, including large public facilities and highway rest stops. Arizona, Illinois, Maryland, Minnesota, and New Hampshire also have taken steps to require them in some public buildings.

Justin Boatner of Arlington, Virginia, advocates for more full-size changing tables in the Washington, D.C., area. Boatner, 26, uses a wheelchair because of a disability similar to muscular dystrophy. He uses diapers, which he often changes himself.

He can lower an adjustable changing table to the height of his wheelchair, then pull himself onto it. Doing that is much easier and more hygienic than getting down on the floor, changing himself, and then crawling back into the wheelchair, he said.

Boatner said it’s important to talk about incontinence, even though it can be embarrassing. “There’s so much stigma around it,” he said.

He said adult changing tables are still scarce, including in health care facilities, but he’s optimistic that more will be installed. Without them, he sometimes delays changing his diaper for hours until he can get home. That has led to serious rashes, he said. “It’s extremely uncomfortable.”

Iowa legislators in recent years have considered requiring adult changing tables in some public restrooms. They declined to pass such a bill, but the discussion made Iowa Department of Transportation leaders aware of the problem. “I’m sorry to say, it was one of those things we’d just never thought of,” said Michael Kennerly, director of the department’s design bureau.

Kennerly oversees planning for rest stops. He recalls an Iowan telling him about changing a family member outside in the rain, with only an umbrella for shelter. Others told him how they changed their loved ones on bathroom floors. “It was just appalling,” he said.

Iowa began installing adult changing tables in rest stops in 2022, and it has committed to including them in new or remodeled facilities. So far, nine have been installed or are in the process of being added. Nine others are planned, with more to come, Kennerly said. Iowa has 38 rest areas equipped with bathrooms.

Kennerly estimated it costs up to $14,000 to remodel an existing rest-stop bathroom to include a height-adjustable adult changing table. Incorporating adult changing tables into a new rest stop building should cost less than that, he said.

Several organizations offer portable changing tables, which can be set up at public events. Some are included in mobile, accessible bathrooms carried on trailers or trucks. Most permanent adult changing tables are set up in “family restrooms,” which have one toilet and are open to people of any gender. That’s good, because the act of changing an adult is “very intimate and private,” Baker Curtis said. It’s also important for the tables to be height-adjustable because it’s difficult to lift an adult onto a fixed-height table, she said.

Advocates hope adult changing tables will become nearly as common as infant changing tables, which once were rare in public bathrooms.

Jennifer Corcoran, who lives near Dayton, Ohio, has been advocating for adult changing tables for a decade and has seen interest rise in recent years.

Corcoran’s 24-year-old son, Matthew, was born with brain development issues. He uses a wheelchair and is unable to speak, but he accompanies her when she lobbies for improved services.

Corcoran said Ohio leaders this year designated $4.4 million in federal pandemic relief money to be distributed as grants for changing-table projects. The program has led to installations at Dayton’s airport and art museum, plus libraries and entertainment venues, she said.

Ohio also is adding adult changing tables to rest stops. Corcoran said those tables are priceless because they make it easier for people with disabilities to travel. “Matthew hasn’t been on a vacation outside of Ohio for more than five years,” she said.

Kaylan Dunlap serves on a committee that has worked to add changing-table requirements to the International Building Code, which state and local officials often use as a model for their rules.

Dunlap, who lives in Alabama, works for an architecture firm and reviews building projects to ensure they comply with access standards. She expects more public agencies and companies will voluntarily install changing tables. Maybe someday they will be a routine part of public bathrooms, she said. “But I think that’s a long way out in the future, unfortunately.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Today is Friday, Oct. 4, the 278th day of 2024. There are 88 days left in the year.

Today in history:

On Oct. 4, 1970, rock singer Janis Joplin was found dead in her Hollywood hotel room at age 27.

Also on this date:

In 1777, Gen. George Washington’s troops launched an assault on the British at Germantown, Pennsylvania, resulting in heavy American casualties.

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In 1927, sculptor Gutzon Borglum began construction on what is now Mount Rushmore National Memorial.

In 1957, the Space Age began as the Soviet Union launched Sputnik 1, the first artificial satellite, into orbit.

In 1965, Pope Paul VI became the first pope to visit the Western Hemisphere as he addressed the U.N. General Assembly.

In 2001, a Russian airliner flying from Israel to Siberia was accidentally downed by a Ukrainian anti-aircraft missile over the Black Sea, killing all 78 people aboard.

In 2002, “American Taliban” John Walker Lindh received a 20-year sentence after a sobbing plea for forgiveness before a federal judge in Alexandria, Virginia. (He was released from prison in May, 2019.)

In 2004, the SpaceShipOne rocket plane broke through Earth’s atmosphere to the edge of space for the second time in five days, capturing the $10 million Ansari X prize aimed at opening the final frontier to tourists.

Today’s Birthdays:

Baseball Hall of Fame manager Tony La Russa is 80.
Actor Susan Sarandon is 78.
Actor Armand Assante is 75.
Actor Christoph Waltz is 68.
Singer Jon Secada is 63.
Actor Liev Schreiber is 57.
Actor Abraham Benrubi is 55.
Actor Alicia Silverstone is 48.
Actor Caitríona Balfe is 45.
Actor Rachael Leigh Cook is 45.
Actor Melissa Benoist is 36.
NBA All-Star Derrick Rose is 36.
Actor Dakota Johnson is 35.

Sam Dutcher had just finished running errands when the 18-year-old’s Honda Pilot suddenly began to accelerate, even though his foot wasn’t on the gas pedal. The brake wouldn’t work, he couldn’t shift into neutral, and before long, the runaway SUV was speeding into the western Minnesota countryside with no way to stop.

“I had the brake to the floor,” Dutcher said Thursday, but the SUV kept going faster and faster, eventually reaching 120 mph (193 kpm).

A last-ditch plan averted disaster that September evening — a trooper sped in front of the Honda and Dutcher was told to crash into the rear of his squad car, allowing it to ease safely to a stop moments before reaching a dangerous intersection.

“That was really all I could think of that was going to get him stopped in time,” Minnesota Trooper Zach Gruver said. “We kind of just ran out of time and distance. I really didn’t know of any other way.”

Dutcher, who graduated high school in May and is studying auto mechanics, was driving to the family home near West Fargo, North Dakota, around 7:30 p.m. on Sept. 17 when he realized something was wrong.

“I went to take my foot off the accelerator,” Dutcher recalled. “It wouldn’t slow down.” As the SUV gained speed, Dutcher had two options: Stay on a two-lane road and drive into Minnesota, or hop onto the interstate. Figuring traffic would be lighter, he chose the road less traveled.

Dutcher tried using voice command on his phone to call 911, but it didn’t work. So he called his mom.

Catherine Dutcher was in the drive-thru line at Hardee’s. In her 911 call, she mentioned that the Honda had just been in the shop because the accelerator was apparently getting stuck. Authorities suspect that the SUV’s computer malfunctioned.

The family should take the vehicle in to a dealership for an inspection, a Honda spokeswoman told The Associated Press. The company could not comment further until an inspection was done, she said.

As the Honda sped into Minnesota, Clay County Deputy Zach Johnson reached Dutcher by phone. Dash camera video shows Johnson talking Dutcher through possible solutions. Nothing worked.

Meanwhile, all Catherine Dutcher could do was worry. When she called 911 for an update, she broke.

“They said they’ve got several officers going to him as well as medical,” she recalled. “At that point I kind of lost it because I just imagined him being either seriously injured or dead. I didn’t know how they were going to stop a car that was going that speed.”

Gruver heard what was going on through his radio. His Dodge Charger eventually caught up with the Honda as it was approaching the town of Hitterdal, Minnesota, about 30 miles (48 kilometers) from where the problem began.

Only about 200 people live in Hitterdal, but the highway runs through an area with a couple of stop signs, a railroad crossing and an intersection with another highway.

Gruver raced ahead to keep traffic at bay. His dashcam video showed the Honda zipping quickly past him through town. Dutcher said the SUV was going about 120 mph (193 kph).

Soon, another worry: Johnson warned Gruver that the highway ended at a T-intersection about four miles (6.4 kilometers) away — a two-minute drive at racing speed.

Law enforcement came up with a plan on the fly: Dutcher should drive into the back of Gruver’s squad car as both vehicles were moving.

“Yes, run into the back of his car,” Johnson urged Dutcher in a conversation captured on dashcam video.

The 2022 Honda’s crash mitigation system kicked in at the point of impact, helping ease the collision, Gruver said. The Honda was going about 50 mph (80 kph) when it struck the trooper’s vehicle. From there, Gruver was able to gradually slow to a stop.

Gruver, a married 30-year-old expecting his first baby, was impressed by the young driver who was able to navigate a runaway vehicle at unimaginable speeds.

“Sam did great,” said Gruver, who has been a trooper for over three years. “I don’t think there’s a whole lot of people that could deal with that pressure.”

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