Appalachian counties are expanding efforts to help ensure children are off to the right start in their education.

Research shows attending a high-quality preschool before kindergarten can boost well-being and economic outcomes later in life but most rural kids lack access to these types of centers or such programs as Head Start.

Cathryn Miller, West Virginia state director for Save the Children, said rural community leaders in Nicholas County have formed a local steering committee to tackle the issue.

"Ranging from education professionals, health care providers, child care providers," Miller outlined. "We have local government officials included, caregivers and just other folks in the community."

Rural child poverty can also worsen learning gaps. Miller pointed out in some West Virginia counties where Save the Children programs operate, the child poverty rate is as high as 38%. According to the National Rural Education Association, nearly one in seven rural students experiences poverty, one in 15 lacks health insurance and one in 10 has changed their residence in the past year.

Miller added the steering committee is looking at the root causes driving setbacks in early learning.

"That will enable the group to explore what's driving kindergarten readiness outcomes that our school districts are seeing, and identify key areas for intervention," Miller emphasized.

Nick Carrington, managing director of community impact for Save the Children, stressed rural kids across the nation face systemic barriers to receiving a good education, especially very young children.

"Rural areas themselves have been under-resourced historically, with just 7% of philanthropic dollars going to rural places that represent more than 20% of the national population," Carrington reported.

Federal data show more than half of rural families with kids under age 5 live in a child care desert.

The lack of quality child care for infants and toddlers costs Colorado nearly $3 billion each year in lost earnings, productivity and revenue but an initiative in Mesa County shows what is possible when local governments, businesses and civic groups team up.

Keller Anne Ruble, client success manager for the data firm BridgeCare, said officials saw huge demand for child care in the town of Clifton, but no providers. So they built a new facility that provides child care and also trains new caregivers.

"So that they can meet the needs of working families and invest in their early care workforce pipeline," Ruble explained. "And because of that investment, they now have 270 seats at this child care center, and they've completely eliminated their child care desert."

Budgetary constraints imposed by Colorado's Taxpayer Bill of Rights make it much harder for the state to invest tax revenues in initiatives such as the one in Clifton. The state also recently froze enrollment in the Colorado Child Care Assistance Program. Over the past 15 years, Colorado's economic growth has dropped from fifth in the nation to 41st, according to the 2025 Colorado University Leeds School of Business report.

Half of Colorado parents said they have quit jobs, worked fewer hours and taken unpaid time off. In 2023, more than 10,000 moms left the workforce, all because of a lack of child care.

Ruble emphasized when the cost of child care is too high, many parents just cannot afford to go to work.

"Families across the country are spending up to 60% of their income on child care," Ruble pointed out. "That's equivalent to a second mortgage or a second rent payment."

Children younger than age 3 are experiencing one of the most crucial periods of brain development and Ruble stressed investing in quality care is important for their long-term health.

"When young children have high-quality, enriching early experiences with trusted caregivers, it sets them on a strong foundation for growing, flourishing into thriving adults that contribute to our workforce and our society," Ruble asserted.


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The number of Kentucky children enrolled in preschool increased in 2024, along with state spending per child, according to new data from the National Institute for Early Education Research.

The commonwealth spent around $6,500 per child during the last academic year, an increase of more than $800 from the prior year.

Steve Barnett, founder and senior director of the institute and the study's co-author, said it is unrealistic to think states could replace cuts to Head Start funding amid the Trump administration's proposed freezes of federal grant funding.

"And particularly replace it overnight if the program is suddenly defunded," Barnett emphasized. "States are going to have to step up and figure out what to do if that happens."

He added if Head Start funding is eliminated, access to public preschool will decline in several states by more than 10 percentage points, and in some, by 20.

Kentucky lawmakers have taken recent steps to expand preschool access, including passing House Bill 695, which established the Adaptive Kindergarten Readiness Pilot Project. The measure aims to provide no-cost, online education for 3- and 4-year-olds who may not be attending state-funded preschool programs.

Allison Friedman-Krauss, associate research professor at the institute, said states spent more than $13 billion on preschool last year, including $257 million in federal pandemic relief funding, in part to attract more qualified teachers.

"We also see in our data that many states are reporting teacher shortages in early childhood, that they've had to increase their waivers in order to get teachers in classrooms," Friedman-Krauss reported.

Research shows toddlers who attend preschool are more prepared for elementary school and less likely to be identified as having special needs, or be held back, than children who do not.


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Medicaid is in the crosshairs, as Republicans in Congress are expected to lay out proposals in May to cut $1.5 trillion from the federal budget, prompting strong opposition from educators.

Around 15 million Californians rely on Medicaid, known here as Medi-Cal, for their health care. However, as Mayra Alvarez, president of the Children's Partnership, noted, the cuts would also deal a devastating blow to schools.

"Medicaid is the third-largest source of funding for K-through-12 public schools to help children have access to routine health screenings, preventive services and physical speech and occupational therapies," she said.

The Trump administration is looking for savings to fund the president's other priorities, including extending his 2017 tax cuts, which primarily benefit the wealthy and corporations. School districts are uneasy because they are legally required to provide accommodations for students with disabilities, regardless of how much the federal government is willing to reimburse.

Sacramento County schools superintendent David Gordon said districts would have to make big cuts across all programs.

"Without those funds, there would be a huge bill," he said, "and school districts would be forced to basically play financial roulette to figure out what do we cut?"

Gordon said his district uses Medi-Cal funds to place mental-health clinicians at each school site, so students with psychological needs get early diagnosis and treatment.

Shana Hazan, a trustee for the San Diego Unified School District, said people don't realize the critical role districts play in providing health-care services.

"Students rely on Medi Cal for things like audiology, mental-health support, nursing and wellness, occupational and physical therapy, home hospital care," she said. "These are really essential for many students with the highest needs."