Work First Plan Approved 01-20-1998-9a

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7. Child Care Several major problems exist that compromise the quality, affordability and availability of child care and early childhood education for Orange County's children. Child care costs more in Orange County than anywhere else in North Carolina. The market rate for child care for an infant or toddler exceeds $6,500 a year; for an older preschooler, the typical fee is over $5,400 annually. This means that most parents with preschoolers in our community have great difficulty paying the full cost of child care. Many families who need help paying for child care are not eligible for assistance. Families earning more than 75% of the state median income are not eligible for child care subsidy through the state's child care subsidy program. Child care subsidy can make the difference between work and welfare. Without child care subsidy, low income parents are often faced with the choice of paying 30-40% of their gross income for child care or not working and relying on pubic assistance. The Work First Program requires that most parents to work. Virtually all of the Work First parents who find work will need assistance with payment of child care. As the requests for subsidies increase, Orange County will be faced with finding additional funds for child care. 8. Health Care All Orange County residents are within close proximity of two teaching hospitals and major medical centers: the UNC Hospitals and Medical School at UNC -CH and the Duke University Medical Center in Durham. Durham Regional Hospital in Durham also serves Orange County residents. UNC Hospitals, as the major state supported hospital in North Carolina, serves a majority of the state's low income population. Orange County's low income residents are also served by the Orange County Health Department, which has offices and clinics in Hillsborough and Carrboro, and the Piedmont Health Center, a private not for profit health clinic in Carrboro. Orange County has a higher per cent of citizens with health insurance (74.6 %) than the state as a whole (64.5 %). For those Orange County residents in poverty, 49.6% have private insurance as compared to 15.8% statewide. Many of these families are employed by the state, either at UNC- CH or UNC Hospitals. Although they are working full -time and receiving health coverage through the state plan, they cannot afford to pay to have their dependents covered and their wages do not lift them out of poverty. This means that children are uninsured. Although Orange County has a higher per cent of all its citizens with health insurance than the state as a whole, the table below shows that a lower per cent of the poverty population has insurance when compared to the state as a whole. 9 10