How Missouri Employers Are Tackling Rural Childcare Shortages with State and Federal Support
- To help rural healthcare employers expand childcare options and assist communities in tackling shortages, Missouri has distributed $1.46 million through the federal Rural Health Transformation Program.
- The $1.46 million allocation comes from the Rural Health Transformation Fund, which was created under the federal One Big Beautiful Bill Act, or H.R.
- The remaining funds will support community planning efforts, with a goal of reaching eight rural health hubs throughout the state over the next year.
To help rural healthcare employers expand childcare options and assist communities in tackling shortages, Missouri has distributed $1.46 million through the federal Rural Health Transformation Program. The state is directing the funds to Child Care Works, a program launched in 2025 that helps employers cover childcare costs for their staff. Brian Schmidt, executive director of Kids Win Missouri, said 32 employers are actively offering childcare benefits through the program, with more working through enrollment.
Targeting Rural Health Funding for Childcare
The $1.46 million allocation comes from the Rural Health Transformation Fund, which was created under the federal One Big Beautiful Bill Act, or H.R. 1. The legislation set aside $50 billion nationally to be divided among states to help offset an estimated $17 billion in federal funding losses in Missouri alone, according to KFF estimates. Missouri received just over $216 million under the fund in its first year. About $750,000 of the new rural health funding is reserved directly for childcare costs, which Schmidt estimates will cover expenses for approximately 250 children.
The remaining funds will support community planning efforts, with a goal of reaching eight rural health hubs throughout the state over the next year. These federal dollars bring together parents, childcare providers, employers, schools, and healthcare providers to parse out each community’s needs. For employers weighing whether to try the program, Schmidt said that doing nothing has a cost, because it is harder to attract employees and harder to retain them.
Bridging Gaps for Missouri Pharmacy Workers
Local businesses have experimented with direct benefits ahead of state intervention. Abe Funk, owner of John’s Pharmacy in Cape Girardeau, Missouri, opened an employee daycare in 2023 after a staff member stated she would likely have to leave work following the birth of her second child. Funk’s pharmacy covered about half of the childcare costs as an employee benefit, but some workers still struggled to cover the remainder because they earned too much to qualify for other subsidies yet too little to pay out of pocket easily.
When Missouri launched Child Care Works in 2025, Funk signed up to add state assistance to the support his pharmacy already provided. You’re not making anything on it, you’re paying into it, but if we didn’t have staff, we couldn’t stay open,
Funk said.
Navigating Rural Childcare Deserts
Affording care is only half the challenge in rural Missouri, where finding an available opening remains difficult due to a severe shortage of facilities. An assessment released in March by the University of Missouri Extension revealed that non-metro counties provided an average of 2.9 childcare slots per 10 children under age 5, whereas metro areas averaged 5.1 slots. Since early 2025, Missouri has lost at least 94 childcare facilities, according to the MU Extension analysis.
Those shortages create annual economic losses exceeding $1.1 billion when factoring in staff turnover, lost wages, reduced tax revenue, and productivity drops. Child Care Aware of America estimates Missouri’s average monthly price of full-time childcare at $1,036 per child, representing about 15% of the median household income for families with children under 6. For single-parent families, that price jumps to 36% of the median household income.
Patty Cantrell, the project development director at New Growth in El Dorado Springs, Missouri, said families in her region navigate provider shortages and affordability problems daily. New Growth has worked with four rural counties to develop a childcare action plan, helping onboard seven employers into Child Care Works, including childcare businesses, a manufacturer and a food truck. Expanding care beyond typical daytime hours remains difficult because providers need sufficient families using those hours to cover operating costs.
The Rural Health Transformation Program funding arrives as Missouri continues to track and address economic losses exceeding $1.1 billion annually from its broader childcare shortage.