Several highly publicized incidents involving child care facilities helped prompt Gov. Mike Parson in March to create a Child Care Working Group to begin looking at ways to ensure safe, quality child care for Missourians.
On Friday, the group presented its recommendations to Parson - ranging from improving background screenings for child care workers to revising regulations to improve safety and quality.
The report pointed out the Missouri General Assembly has of late taken steps to improve safety of children under care.
During this legislative session, it passed House Bill 397, which included provisions to limit in-home child care facilities to six or fewer clients - Named "Nathan's Law" after 3-month-old Nathan Blecha, who died from suffocation in 2007 at an unregulated in-home day care in Jefferson County. The facility was at the time serving 10 children, with no more than three that are younger than 2 years old at the same address.
It increases the fine for illegal care from an infraction to a misdemeanor and allows the Missouri Department of Health and Senior Services to assess fines related to illegal care, or to file suit in circuit court to prevent imminent bodily harm to children, according to the report.
DHSS also is conducting comprehensive background checks on people who apply to work at child care centers. Anyone found to have a criminal history of a felony or misdemeanor against a child or drug convictions in recent years is prevented from working in the facilities. The agency also prevents employment of registered sex offenders or anyone with a history of child abuse or neglect.
The report calls for - at a minimum - the use of Family Care Safety Registry for child care providers that are exempt from license registry, such as those operated by religious organizations. The registry would include a background check and child abuse screening for Missouri. It requests the expansion of background checks to include those done by the FBI because many child care workers may live in a neighboring state and commute to Missouri for their job.
The working group was made up of staff from Parson's office, the attorney general's office, DHSS and departments of Social Services, Public Safety, and Elementary and Secondary Education.
The group held several meetings, including a stakeholders meeting in early May.
During that meeting, child care facilities owners, like Julie Schmitz, director of Show-Me Child Care Center in Jefferson City, said the number of children with special needs enrolled in child care increases every year. She said child care providers don't have the flexibility to go into a community and get specialized training they need.
The report calls for improvements to professional development for the early childhood workforce by providing guidelines on competencies expected of a quality workforce, professional development activities for improving the knowledge and skills of the workforce, a mechanism for tracking professional development, and the ability to apply qualified activities to an advanced degree.
If child care facilities' licenses - which are valid for only two years - were "non-expiring," they would eliminate the renewal process, which is time-consuming for the applicant and DHSS.
The change would allow DHSS to continue to regulate child care programs through inspections and legal actions to protect health and safety of children, according to the report.
The report calls for stricter regulation of small children when they are playing outside child care facilities. Missouri facilities can currently allow children 3 and older to play outside without an adult present if the caregiver provides "frequent supervision," according to the report.
Caregivers should provide "active supervision of children by sight and hearing at all times," including when they are outdoors. Outdoor supervision should be at least the same, "if not higher," than that provided indoors because children are more active outdoors, the report states.
Current law allows facilities to determine the necessary depth of shock-absorbing surfaces on playgrounds. It would be better, the report said, to set standards for playgrounds.
The group determined serious injuries to children occurring in facilities aren't reported frequently enough.
"Require child care providers to report serious injuries and child deaths that occur in the child care setting in rule," the group recommends in the report.
Current Missouri child care licensing rules only include requirements of group sizes for infants through age 2. The report calls for child care facilities to have rules regulating how many preschool and school-age children it assigns to a caregiver, teacher or team of caregivers.
"Larger groups are generally associated with less positive interactions and developmental outcomes," according to the report. "Group size and ratio of children to adults are critical factors in children's health, safety and development."
A challenge, officials learned from the stakeholders meeting, was that communication between state officials, child care providers, and parents and the public was limited. The report calls for a streamlining email service between stakeholders, creation of an early childhood website to be used across state departments, and development of an early childhood care and education web page.
"The need to protect the health and safety of children is paramount," the report states. "Parents and caregivers who are working or pursuing their education should not have to worry about the safety and well-being of their children in a child care setting."
The report can be found at health.mo.gov/safety/childcare/pdf/cc-work-group-report.pdf.