The state distinguished 27 classes of child care service, based on age of child, hours of care per day, and size of the child care provider. For each of seven geographic areas in the state, a maximum subsidized fee for one day's care for each class of service was specified. If a provider's fee was less than this amount the state paid the fee, while if a fee exceeded this maximum, the state paid the maximum and the client was responsible for the difference. Eligible households had their choice of child-care providers. Although the subsidy payment was often made directly to a provider, the subsidy was on behalf of a particular client. Many clients were required to provide a co-payment, which depended on family income and number of children. This co-payment was a fixed dollar amount per day; it did not depend on the fee charged by the childcare provider. (Mueser & Weagley, 1998) Information is provided regarding a study done to determine the effectiveness of this program. There are reasons that care may be necessary inside the home, or additional services. Again, these aspects need to be considered if one has a child with a mental disability. In a review conducted Hernandez & Hodges (2003), explain finding concerning 30 operational systems of care across the country. Various outcomes were reported. These included an array of community-based services for children with serious emotional disturbance (SED) and their families; reduced reliance on restrictive treatment environments and out-of-home placements; increased interagency coordination and collaboration in the planning, development, and delivery of services; flexible services that can be tailored to individual children and families; and (e) cost containment and cost-effectiveness. The researchers conclude that these outcomes indicate that the benefits of systems-of-care implementation are more likely to be found at the organizational level rather than at the individual child and family levels, where symptom reduction and improved functioning are expected to occur.

What affects the choices that parents make in a facility/childcare provider? Research conducted by Noble (2007), explains that the following things effect a parents decisions in a facility/provider. A phenomenographic research approach offers an insider perspective of early childhood services. These categories describe the way parents see ECEC services, as follows: Demographically convenient, parents' thoughts become geared towards issues of demography and/or convenience. Parents expressed the understanding that convenience was related to many factors, including cost, flexibility of operating hours, and proximity to home or their work, as well as availability. Safe, secure, and hygienic, the physical dimensions of the ECEC service as they apply to children; parents were looking for security when choosing a service. A safe, secure and hygienic environment was seen to be one in which children were safe from any form of physical harm. Children were also in a secure environment when they seemed to be happy and well adjusted. (Noble, 2007)

Providing a routine, this conception focuses on the ECEC service as a place where a routine is established and maintained. The routine must be evident; however, it is seen to be vital that it is flexible to suit the child's needs. Within the ECEC service, parents considered it important that children are made aware of the routine, so that they are encouraged to meet expectations and to function as a part of that routine. Further, parents valued being kept informed about the routine, so they could ensure that their child was informed and prepared. Caring and nurturing, this conception focuses on the ECEC service as caring and nurturing. Parents expressed the need for each child to be well cared for in a nurturing environment, with the staff at the service adopting a 'pseudo' parent role and thereby offering the child a high degree of emotional support. Having trained and qualified staff, this conception focuses on the service having trained and professional staff. It seemed very important to parents that they have good 'teachers' in the service. This equated to trained and well-qualified staff. Developing a positive picture of the teacher, and feeling it to be 'good luck' to have that particular teacher, seems important to parents when choosing a particular ECEC service. It makes the parents feel good about another person taking over a lot of control in relation to the child. (Noble, 2007)

Valuing parents and keeping them informed, this conception focuses on the ECEC service as a place where parents are valued and kept informed. It is important that the service value parents and their beliefs, as well as their wishes for their child. Equally, parents expect that they will...

Providing socialization, this conception focuses on the ECEC service as a place where socialization occurs. Parents have described this conception as being two-fold in nature. First, they see that it is necessary for young children to socialize with other children who are similar in age. Second, they state that it is necessary for children to learn to socialize with other adults. Parents feel that children need to learn to cooperate with both other children and adults in ECEC services. Preparing for further learning, this conception focuses on the ECEC service as preparing children for further learning. Parents expect that the service will not only identify the child's current levels of growth and development but will also endeavor to extend the child further. (Noble, 2007)
These eight categories of description are understood and distinguished in terms of three dimensions: physical, personnel, and personal. The physical dimension refers to the location and availability of services catering to the needs of the family. The personnel dimension refers to how ECEC services are judged according to the personnel who work within that environment. The personal dimension refers to how the ECEC service is judged according to how the individual children and their family are catered for and responded to within the environment. (Noble, 2007)

Noble (2007), concludes through the research that when parents choose child care services there are things that influence these choices; Relationship with child influenced by the parents' assessment of the needs of the child and the family and how the reactions of the child influenced that choice. Influence of significant others, this category revealed that parent choice was influenced by the opinion of others within the social context. Parents indicated that their choice of ECEC service was guided by hearsay, rather than making a choice independently according to available market information. Obtaining the opinions of others who had utilized the ECEC service beforehand, and who therefore had previous experience, was important to parents in considering ECEC services. Understandings of childhood, the parents were influenced by their understandings of what they wished childhood to be like for their children. Parents viewed ECEC services as providing opportunities for their children to feel secure, comfortable, and stimulated, while at the same time making connections between the home and centre environments. Maximizing the child's potential, Parents were influenced by the notion of expected outcomes for their child. Parents may view the role of ECEC services as spaces for promoting development, ensuring readiness to learn, readiness for school and enhancing school performance which was suggested through supporting research in the documentation Noble; therefore the choice of service can be influenced by its perceived ability to focus on such aspects.

Parents also highlighted the fact that at times their choice of ECEC service was mediated by pragmatic concerns. They chose services that met the practical needs of their family in terms of co-location of children, affordability, and demographic convenience. Therefore, while parents may hold an idealistic perspective of what they wish for in an ECEC service, they may not find it in their local community and, instead, make their choice based on availability. Some parents make their choice based on pragmatic factors alone, as meeting the needs of the family is deemed most important. What is evident is that, because of the limited number and range of ECEC services in particular locations, the ECEC market can rely heavily on the opinions and perceptions of other parents already using a particular service, or those who have previously experienced the service. (Noble, 2007) review by the National Academy of Science reported six studies as finding relations between process quality and children's behavior in the child care setting, and six studies as finding relations between structural/caregiver characteristics and child behavior in the child care setting. To summarize these findings, children appeared happier and more securely attached to caregivers in care settings in which process quality was higher and adult-child ratios were lower. Children appeared more pro-social and positively engaged with peers when caregivers were sensitive and positive to them and when child-adult ratios were lower. Children were rated as more cognitively competent during free play in child care settings that offered more opportunities for art, blocks, and dramatic play, and in settings in which caregivers had college degrees and more early childhood training. (Vandell, 2004)

There is considerable insight into the effect of…