This report begins with an overview of ECEC service provision in the United States. It then describes refugee populations in Massachusetts and how refugee families access child-care services, including the process of obtaining child-care vouchers and connecting with ECEC providers. It reviews the challenges to ECEC access faced by refugee families and then explores the strengths and weaknesses of the existing ECEC system, including the frameworks of case management, public benefits, and provider referrals that shape access to ECEC services. Next, the report examines national, state, and local initiatives that seek to improve how refugees access ECEC services, and how stakeholders can work together more effectively to strengthen this process. Finally, it offers a set of Massachusetts-specific policy and program recommendations for resettlement agencies, the Massachusetts Office for Refugees and Immigrants (ORI), the Massachusetts Department of Early Education and Care (MDEEC), and other state agencies to help address system barriers in this area and provide refugee families access to the widest possible range of ECEC options. (author abstract)