Over the course of several Roundtables held with out-of-school time program providers involving dozens of organizations, Child Trends has learned a lot about the concerns and wishes of the hardworking people who run out-of-school time programs. In this brief, the author and her colleagues share several themes that have emerged from these discussions. Not surprisingly, Roundtable participants identified funding as an overriding concern. But they also shared other concerns that affect their abilities to implement effective programs. These concerns included the difficulties in attracting, training, and retaining highly qualified staff; the challenges associated with being accountable to funders; the need for greater flexibility to meet program needs; and the organizational dilemmas faced by small programs. (Contains 1 footnote.)