When the COVID-19 pandemic hit Missouri, child care centers already operating on razor-thin profit margins took a huge hit.

"This has caused a massive disruption in the child care industry and put many centers at risk of closing," said Casey Hanson, director of outreach and engagement for Kids Win Missouri.

The organization interviewed more than 100 child care providers between April and June, publishing the results in a report called "Paving the Road to Recovery for Families." It calls for Congress to approve a $50 billion aid package for the child care industry.

The report’s findings on Tuesday were part of an online video presentation.

"Our already fairly fragile child care infrastructure is really overwhelmed," Hanson said.

Child care centers have dealt with added costs related to new procedures and practices. Maintaining staff levels is a significant concern for providers.

"There’s a lot of risk and it’s a low-paid job without health benefits," Hanson said.

Robin Phillips, CEO of Child Care Aware, an organization that supports Missouri child care centers, said of 3,343 centers and programs in its database, 2,182 are at least partially open and 1,161 have not reopened.

"Child care is infrastructure," Phillips said. "Just like a bridge. Just like a road."

Briarwood Early Learning is a home-based child care center in Columbia. It closed for seven weeks, said owner Amanda Atkins.

"I re-opened in mid-May, hesitantly," Atkins said.

Her center wasn’t approved for funding under a first round of the federal Paycheck Protection Program, but received money in the second round.

Atkins worries about the emotional needs of the children in her care, she said. She’s convinced a future closure will be required.

"These children are not social distancers," Atkins said. "They don’t care if they share their germs with you."

It’s a high-risk profession, she said.

Many other child care centers have experienced hardships during the pandemic and stay-at-home order.

Operation Breakthrough in Kansas City has had to turn families away because they had visited a COVID-19 hot spot and had to be quarantined, said CEO Mary Esselman

There was no central source of information, Esselman said.

"We’re going to see a whole different world as school starts," she said.

Good Shepherd Preschool and Infant Toddler Center in St. Louis remained open for children of health care workers, said owner Cortaiga Collins.

"We are operating with double the staff, half the capacity and increased supply costs," Collins said.

The Missouri Department of Social Services was slow to release information initially, she said.

Boys and Girls Club of the Ozarks, in Branson, lost $500,000 in revenue this year, said CEO Stoney Hays.

"Who does that impact? Our staff," he said.

As children returned to the club, calls to Child Protective Services about suspected child abuse while children were at home increased, Hays said.

"I’m confident that, unfortunately, trauma is going to come out in the long run," Phillips said.

What happens to children in the first five years of their lives will affect their outcomes in their teen years and adulthood, she said.

U.S. Sen. Patty Murray, D-Washington, is sponsoring the Child Care is Essential Act, which would provide the $50 billion to child care centers. Congress has from about July 20 to the first week of August to debate it, said Craig Stevenson, Kids Win Missouri director of policy and advocacy.