The Massachusetts Department of Early Education and Care announced on Friday that it's phasing out a state-sponsored COVID-19 testing program that thousands of child care programs across the commonwealth have relied on over the last year.

The announcement — which came two weeks after the state relaxed quarantine guidelines for child care, but before federal approval of COVID-19 vaccinations for children under 5 — only adds to the uncertainty for day care providers on how best to keep children and staff safe.

Winding down the testing program

In an email to child care providers, the state Department of Early Education and Care announced it will end the COVID-19 testing program at the end of this month. The program, which has been run by the nonprofit Neighborhood Villages, provided tests to centers each month and included a system for reporting and tracking positive cases.

The state's contract with Neighborhood Villages was set to expire at the end of this month, and child care providers told GBH News this spring that they were worried the program might not be renewed. Even though the program is ending, the state says it will continue to provide free rapid antigen tests to providers on a quarterly basis through the end of December.

The state is also closing drive-through testing sites in Braintree and Tewksbury that were exclusively serving child care staff and families with kids in those programs. State officials have not yet said whether they'll continue offering a "surveillance" program of weekly PCR tests that several hundred child care providers have been using.

One of the centers that's been participating in the PCR testing program is Temple Beth Shalom in Needham. The program serves about 220 children and is run by Ellen Dietrick, who told GBH News she's worried the state will end PCR testing.

"I think that testing is one of the very few methods we have to protect these under-fives," Dietrick said, noting kids that age are terrible at social distancing and still unvaccinated.

The state's email on Friday said Neighborhood Villages will continue to offer a phone hotline through the end of August, "to support the implementation of recently updated guidance and other COVID-19 related inquiries."

Relaxing state quarantine guidelines

Day care providers were already feeling uneasy with new quarantine guidance issued by the state Executive Office of Health and Human Services about two weeks ago.

On May 25, EOHHS announced that, effective immediately, children were no longer required to quarantine if they've been exposed to someone who has COVID-19. The guidelines said those children should continue attending child care programs, and that while testing is recommended for those kids, it's not required.

The state says the changes were made to be more consistent with the guidelines for K-12 schools, after-school and camp programs. Still, the abrupt shift left some child care providers feeling less protected.

"So theoretically, you could have a young child who has a family filled with positive family members — including their own parents ... and according to these guidelines, that exposure does not mean that the child should stay home," said Lauren Cook, CEO of Ellis Early Learning, which serves 250 children at three child care locations in Boston. "And we've seen at Ellis, based on our experience, that it is highly likely a young child will test positive within probably five days of the parents being positive."

The new guidelines also say that children who do test positive for infection can return to child care settings after they've quarantined for five days, as long as they're asymptomatic and able to mask.

Cook pointed out, though, that many programs provide breakfast, lunch and a snack each day.

"So that's three instances where kids are maskless," she said. "And then naps are usually over an hour where kids are maskless. So are we defining 'able to mask' as children who are taking their masks off for all those periods of time?"

Unlike public schools, most child care providers are private organizations that can make up their own rules. But Cook said she'd likely receive pushback from parents if her program adopted rules that were more stringent than state guidelines. She said she plans to poll parents to see if there's support for a policy that she feels would be more protective.

For the youngest kids, vaccinations haven't started yet

The scaled-back testing program and quarantine requirements come before children under 5 can get vaccinated. That could soon change, as the Food and Drug Administration and Centers for Disease Control and Prevention are expected to approve vaccinations for the youngest children as soon as this week. But it will likely be months before a significant percentage of kids get shots.

"At this point, these little ones have no protection at all," said Ellen Dietrick at Temple Beth Shalom. "There's nothing. And some can't even wear masks."

She emphasized that child care staff are also at risk.

"These teachers are going to a work environment where no one is vaccinated. They are the only vaccinated individual in a room of 20 people," Dietrick said. "So protecting them is really critical. I mean, we have to protect them or we can't run the program. If they are out sick, that affects 20 families."

The state of child care funding is uncertain

The uncertainty over testing comes as child care programs also face the possible end of a state grant program that has helped keep them open during the pandemic.

A system known as C3 grants(which stands for Commonwealth Cares for Children) was set up last year using federal funds to help keep child care organizations from closing due to a loss of revenue because of the pandemic. Now that the one-time federal funding is gone, the grant program is set to expire this month.

"It has been a godsend," William Eddy, executive director of the Massachusetts Association of Early Education and Care, said of the C3 grants. "It helped programs that were on the verge of collapse stay alive."

Ellen Dietrick said the grants have been enormously helpful to programs like hers in Needham.

"Most people are using it to pay for staff salaries, bonuses, anything to keep our teachers," Dietrick said. "That is the most important thing."

Others used the grants to help when they got behind on rent while closed because of the pandemic, she said. And programs have come to rely on the funds.

"Many of us don't know how we'll continue without getting the funding for next month," she said. "And I mean, we're talking about in three weeks."

The future of the grant program depends on where things land in current budget negotiations between the state Senate and House of Representatives, Eddy said. That budget is due at the end of the month.

"We asked for them to continue [the C3 grant program] for the six to eight months, and hope they do," Eddy said.

The Massachusetts Legislature is negotiating what could be a boost in funding for early education after a special legislative commission issued a report in March that called for a significant increase.

"The commission recommendation said there are over 230,000 children who are currently eligible for subsidy care who are not receiving it right now," Eddy said. "And so they said we should prioritize trying to help them. They came up with recommendations to prioritize the early educator workforce, which is struggling mightily."

That prioritization is beginning to be seen in draft House and Senate budgets, Eddy said, and he's closely watching what comes out of their negotiations.

"I'm hopeful that the state Legislature is going to put a record investment into early education programs and our workforce in the FY23 state budget," Eddy said.