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Safety, quality lead concerns for Missouri child care

Safety, quality lead concerns for Missouri child care

May 5th, 2019 by Joe Gamm in Local News

Maurice Wallace, 4, plays with dinosaurs Friday at the Apple Tree Academy. Gov. Mike Parson recently created the Child Care Working Group to look at child care in the state and provide recommendations on how best to ensure safe, quality child care that would promote his Workforce Infrastructure Initiative.

Photo by Sally Ince /News Tribune.

Missouri may not have to reinvent the wheel when it comes to child care, but it has to be aware that not every wheel fits every need, members of the Missouri governor's Child Care Working Group said Wednesday.

The group has looked at how other states conduct the business of child care, and found Tennessee, Maryland and several other states have enjoyed successes beyond their peers.

Made up of staff from the governor's office, the attorney general's office and state departments of Health and Senior Services (DHSS), Social Services (DSS), Public Safety, and Elementary and Secondary Education (DESE) — the group came about, in part, in response to several highly publicized incidents of children being mistreated at day care centers.

But, improvements to the state's child care system will also help assure improved "workforce infrastructure," according to DHSS Director Randall Williams.

"It's incredibly important to (Gov. Mike Parson) as part of his Workforce Infrastructure Initiative," Williams said. "If it's important to have a strong workforce, we need to have strong child care."

Spearheaded by DHSS, DSS and DESE, it is tasked with making recommendations to the governor June 1 about how best to ensure safe, quality child care.

"He's asked us to look — primarily through those three departments — at regulations and come up with our recommendations on what we would change," Williams said.

The three agencies have worked well together under Parson, so after the recent releases of recordings of child care workers abusing children (particularly in Missouri), the governor asked them to work together to determine if the incidents were confined to local communities or systemic in nature. The group was to find out of there are processes that must be improved upon.

Some stakeholders in the process, during a meeting Wednesday, said the system may be partly at fault.

But, it's not certain.

Williams expects to make solid, actionable recommendations early next month.

"I think the release of the report on June 1 will be the start of a conversation — ongoing, if you would — that won't stop with that report," Williams said. "My prediction is that out of our recommendations, we'll start a longer — nine-month-to-a-year-process — to dive even deeper."

The group is also expected to recommend that the governor look deeper into the state's organization — in how it provides child care and other issues, Williams continued.

Childcare Aware of America, a national nonprofit organization whose mission is to advance child care that effectively serves all children and families, provides fact sheets on its website, childcareaware.org, for child care in each state.

For example, it posts the number of child care facilities, whether center-based, faith-based, in-home and otherwise on its website. And it includes the number that are nationally accredited.

The organization creates an annual report — the State Fact Sheet — which looks at how child care looks overall.

"To remain competitive in the 21st-century global economy, the United States must recognize the value of child care in early childhood education and as a support system for working families," the 2018 report states. "The research is indisputable: young children participating in high-quality programs demonstrate lasting improvements in IQ, boosted academic and economic achievement, and lower incidences of childhood obesity and chronic illness."

Any infrastructure investment should include a similar investment in child care, the report concludes.

Sue Porting, administrator for the DHSS Section for Child Care Regulation, said there are a wide range of programs across the country. There are certain states that are leaders in different areas, she said.

Missouri is a part of a region receiving Child Care Development Fund monies, with Kansas, Iowa and Nebraska. Porting said she went to a meeting with state workers from those other states about a week ago.

"It was interesting, listening to what staff in other states are going through," Porting said.

They are experiencing similar struggles with federal changes as Missouri staff, with the fingerprinting, background screenings and how each state is implementing the process.

Porting said child care providers tell her they are challenged because the population within the centers is changing.

"Years ago, you had one child in the entire center that had behavioral issues," a provider told her. "Now it's about four out of 10."

The staff and caregivers don't always have the tools and skills to deal with the situations, Porting said.

Those tools may not be available, according to Julie Schmitz, director of Show-Me Child Care Center.

The state, which requires 12 hours of continuing training every year for child care workers, provides those opportunities through a partnership with Child Care Aware of Missouri.

Schmitz has dropped coverage of foster care children from her program, in part, because the state didn't have adequate training for dealing with the children, who sometimes have behavioral issues.

She said she could get training through St. Mary's Hospital, but the state wouldn't recognize the training and give staff credit for the hospital's programs.

As child care providers, people who operate centers value their clients' safety and conform to an overwhelming set of guidelines provided by the state, said Karen Werner, who operates two child care facilities in Jefferson City — Apple Tree Academy and Big Top Development Center.

"We have pages upon pages of safety guidelines, including child abuse and neglect, background screenings, hotlines, how to identify child abuse and neglect," Werner said. "A lot of training is already in that."

State regulations already spell out what needs to be done to meet health and safety standards, she added.

Staff at her facilities are already trained to identify child abuse and neglect — and they are mandatory reporters. So, if they witness something, or suspect something, they are required to report it.

"The hotline is available," Werner said.

And, there are multiple safety requirements in place, such as the documentation of medications. For example, Schmitz said, although many child care providers don't agree with a requirement that they document application of sunscreen, they do so.

"We are asked to report any serious injury to a DSS inspector," she said. "There are good things in place."

Child care providers have some discretion for determining what can be reported to the DSS. While they have to report any serious injury, if they reported to DSS inspectors each time a child fell and skinned a knee or elbow, the inspectors would be overwhelmed.

They still have to notify parents of incidents.

A change in safety that is concerning — looking ahead — Schmitz said, is a mandate that drivers for the centers are to carry a tablet and sign children in and out each time they pick them up.

"The whole community is going to see my driver on a tablet, which looks like a phone," she continued. "They are going to call me and tell me they saw my driver on a phone. The DSS is (implying) that this tablet is more important than the children behind them. I struggle with that."

Certainly, the drivers won't be filling out the tablets while driving, but to passersby, it will appear they are on a phone when they should be working.

Accidents happen when children are stepping into the van, she said.

Quality of care and education is another concern for the governor and for providers.

The licensing book the state gives to child care centers really defines the quality of services they can provide, Werner said.

The book gives minimum standards for building safety, program expectations and staffing levels.

Yet another challenge is finding and keeping qualified staff.

"Staff work for us while they're earning their degrees," Werner said. "When they get their degrees, they move on to public schools. They become qualified teachers. They work for us all through college. They graduate — and they're on their way."