Unlicensed Child Care Puts Children At Risk

The Child Care and Development Block Grant (CCDBG) is allocated to states to both assist families in affording the cost of child care and to improve the quality of child care (such as through training or other activities). In October, new state reported child care data was released by the U.S. Department of Health and Human Services (HHS) with regard to the number of low income children in each state assisted through  CCDBG.  boy playing w blocks, verticle stock

Overall in FY2013, about 1.4 million children received assistance each month (about 47,500 fewer children in 2013 compared to 2012). The number of children receiving assistance is one part of the story. An equally important part of the story is the type of child care paid for by CCDBG.

In many cases, low income families who receive assistance are able to access quality child care that they would not otherwise be able to afford.  That’s good news for children who will be in a safe setting that promotes their healthy development. And, great news because research shows that high quality child care makes a difference for all children, but particularly for the school readiness of low income children.

What is troubling is that of the 1.4 million children receiving federal subsidies, about 15 percent (218,265) are in unlicensed care. This means that these children are in settings where little is known about the provider except that she receives a government check to care for low income children. In many states, these unlicensed providers are not required to have training, there are no minimum health and safety protections for children (or maybe there is a checklist that providers submit “self-certifying” compliance) and no inspections are required – unless there is a parent complaint.

In 11 states plus Puerto Rico, 25 percent or more of the children receiving a subsidy are in unlicensed care (Hawaii, Oregon, Alabama, Puerto Rico, Nevada, Illinois, Connecticut, Michigan, New York, Missouri, North Dakota, and Indiana).

unlicensed by percentage snapshot fy2013

In 18 states, of the children in unlicensed settings whose care is paid for through CCDBG, more than half of the children are with non-relatives.

Unlicensed NonRelative Care Declining FY2013

Why does it matter? Child care licensing serves to provide some minimum health and safety protections for children in child care. States may require minimum training for providers and an emergency plan in the case of a fire or simple things like working smoke detectors and a fire extinguisher. In the past month in Virginia, 3 babies have died in unlicensed at home child care programs where providers had no training for emergencies, no fire extinguishers, and no working smoke detectors.  For Virginia, 46 infants have died over the last few years in unlicensed care. In Missouri, more than 67 babies have died in unlicensed care.  In Indiana, 18 babies have died in unlicensed care. Maybe some of these children were on a subsidy, but we don’t know because current law does not require reporting of this type of data.

The death of any child is a tragedy. It’s an even greater tragedy when the deaths can be prevented. Licensing  serves to protect the health and safety of children. One would think that when taxpayer dollars are used to pay for the care of low income children, that the settings paid for would be safe. But, with unlicensed care, we just don’t know. What we do know is that unlicensed care poses risks to children since there are no minimum health and safety protections.

This week, the Senate will consider legislation to reauthorize (renew) the Child Care and Development Block Grant (CCDBG). The bill was approved by the House of Representatives on September 15.  If approved by the Senate this week, the measure will be forwarded to the President to be signed into law. The bill includes important new health and safety protections for children. It requires more accountability for state expenditure of federal funds.  But, most importantly, it will help strengthen the quality of child care in every state so that parents have more choices among quality settings.

Arkansas, Massachusetts, North Carolina, Oklahoma, Ohio, and Wisconsin, choose not to use subsidy dollars to pay for unlicensed care.  For the rest of the states, the bill will require a review of the policies to protect children when the states allow funding for unlicensed settings.  The bill requires:

  • a comprehensive background check (a fingerprint check against state and federal records, a check of the state child abuse registry and a check of the state sex offender registry) for all licensed or regulated care and unlicensed nonrelative care where subsidies are used;
  • States that choose to use subsidies to pay for unlicensed care to publicly explain why such care does not endanger the health, safety, or development of children;
  • At least one annual inspection of all providers receiving a subsidy, including unlicensed non-relative care;
  • Minimum training on important health and safety topics like safe sleeping practices and training related to the social, emotional, physical, and cognitive development of children; and
  • States to report deaths in child care, differentiated by type of setting and whether the setting is licensed or unlicensed.  Requiring the collection of this data is not to be morbid, but to better inform states and HHS about any trends and training that might make a difference.

The bill does not require assistance to families to be used for licensed care. However, it does require states to ensure that if they choose to use taxpayer dollars in unlicensed care, that children are safe. Children should be safe in child care – whether that care is paid for by a subsidy or not.

Congress Reaches Bipartisan Agreement on Child Care!

On September 12, 2014, a bipartisan group of House and Senate leaders announced an agreement on legislation to reauthorize the Child Care and Development Block Grant (CCDBG), which allocates funds to states for child care – to help families afford the cost of child care and assist states in improving the quality of child care. Pre school

While Congress generally reviews laws periodically to adjust them for new research, best practices, and to address any shortcomings not foreseen when bills are drafted (a process referred to as reauthorization,  which generally occurs every 5 years on average), it has been 18 years since CCDBG was last reauthorized in 1996. Much has been learned during the intervening years from the science of brain development to the child care policies within states.  For example, national studies have shown that most state child care policies are weak and the oversight of those policies is even weaker.

Legislation to reauthorize CCDBG was approved by the Senate in March.  The House held a hearing (also in March), to hear from experts about the need for quality child care. This summer, House Republicans and Democrats negotiated a reauthorization bill starting with the measure that was approved by the Senate. With adjournment expected soon this fall, House Education and Workforce Committee members, Chairman John Kline (R-MN), Ranking Member George Miller (D-CA), Rep. Todd Rokita (R-IN) and Rep. David Loebsack (D-IA) reached an agreement and negotiated a final bill with Senate Health, Education, Labor, and Pensions (HELP) Committee members – Chairman Tom Harkin (D-IA), Ranking Member Lamar Alexander (R-TN), Senator Barbara Mikulski (D-MD) and Senator Richard Burr (R-NC).

At a time when Congress is polarized, and budget and international events, engagements, and threats are the focus of contentious debate on the House and Senate floor, it is just short of a miracle that a bipartisan, bicameral, group of leaders came together and reached an agreement on an issue that is critical for working families with children.

The fact of the matter is that working families need child care in order to get and retain a job. Children need a safe place to be and a setting that promotes their healthy development. The Child Care and Development Block Grant (CCDBG) reauthorization bill agreement, as announced yesterday, will both promote children’s safety and improve accountability for the expenditure of federal funds.  It also shows that Congress can come together in a bipartisan manner and in a manner that unites both the House and the Senate on behalf of children.  Kudos Representatives Kline, Miller, Rokita, and Loebsack and Senators Harkin, Alexander, Mikulski, and Burr!  Working families commend your initiative and dedication to push partisan politics aside and support good, common sense policy for children.

The measure is expected to be considered by the House and the Senate during the week of September 15.

Child Care and Development Block Grant Act of 2014

In Brief:  The bicameral, bipartisan, CCDBG agreement reached to reauthorize the Child Care and Development Block Grant (CCDBG) improves the quality of child care by requiring basic health and safety protections for children whose care is paid for by taxpayer dollars.  The funds set-aside for state activities to improve the quality of care will require more accountability for the use of those dollars.  In addition, more emphasis would be placed on strengthening the child care workforce, the cornerstone of quality child care.

For a detailed bill summary, click here. 

For a copy of the bicameral, bipartisan press announcement, click here.

For a copy of the bill, click here.

Child Care Quality Hearing Held by U.S. House of Representatives

On March 25, the U.S. House Education and the Workforce Subcommittee on Early Childhood, Elementary and Secondary Education held a hearing on child care quality. “The Foundation for Success: Strengthening the Child Care and Development Block Grant Program,” was a chance for the Committee with jurisdiction over our nation’s largest source of child care funding to review current policies and practice.

The expert panel at the hearing testifying and responding to questions from Members of Congress:

  • Paula Koos, Executive Director, Oklahoma Child Care Resource & Referral Association

    House Child Care Hearing March 25, 2014

    House Child Care Hearing March 25, 2014

  • Linda Kostantenaco, President, National Child Care Association
  • Dr. Olivia Golden, Executive Director, Center for Law and Social Policy (CLASP)
  • Gloria Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services

Overall, the hearing focused on the affordability, availability, and quality of child care and the services funded under the Child Care and Development Block Grant (CCDBG), the law that allocates funds to the states for child care. CCDBG serves about 1.5 million low-income children throughout the country and invests about $1 billion in activities related to the quality of child care (i.e., activities related to strengthening the workforce and the quality of child care programs, including basic health and safety protections for children).

The reality today is that most parents work. And, in order for families who have young children to work, they need to obtain child care. Finding and affording child care is not easy for parents and most find it a stressful process. The hearing highlighted the role of Child Care Resource and Referral Agencies within the states to both help parents find quality child care and help child care providers offer quality child care.

Paula Koos, Executive Director of the Oklahoma Child Care Resource & Referral Association told policymakers about the unique role of child care resource and referral. She talked about the importance of consumer education so that parents can make informed choices when selecting child care. “ In too many communities today, child care is hard for parents to find, hard to afford, and too often of questionable quality. For low income parents, the task is even more difficult. There are more than 600 Child Care Resource and Referral agencies throughout the country, serving nearly every zip code, assisting parents in finding child care. They help make a stressful and chaotic process calmer and more understandable and help parents make better informed choices in child care. The reality is that there is a large gap between parent expectations and state policy.”

Ms. Koos told policymakers about the gap between parent expectations and child care policies within states. “Parents think that a child care license is some type of gold standard, in short, the state’s seal of approval in order to offer child care. Parents assume a license means that adults providing child care have had a background check and training specific to child care. Parents believe there are required health and safety protections for their children, and some expert does inspections to ensure compliance with laws and policies for child care. Parents also assume that all child care settings are monitored when, in many states, large numbers of providers are legally exempt from oversight.”

Paula Koos, ED Oklahoma Child Care Resource & Referral Association

Paula Koos, ED Oklahoma Child Care Resource & Referral Association

“Child Care Resource and Referral has worked with parents in Oklahoma for more than 30 years. We have eight agencies that serve families in all 77 counties to offer consumer education and referrals to help families make better informed child care choices. We do not make recommendations about child care programs to any family. However, we provide them with information so that they can make an informed decision that meets the needs of their family. Finding child care is a stressful time for parents and our services help to alleviate that stress.

Ms. Koos also told policymakers about the role that CCR&R plays with regard to strengthening the workforce – a key element to improving the quality of child care. “We offer training, technical assistance and consultation to providers. Training is provided in both child-related and business requirements. From guiding people who are thinking about launching a child care business, to assisting providers to offer the best quality of care for children, we offer many services.”

“Training is related to strengthening the quality of the workforce – the competence and skills of the workforce. Technical assistance has many forms, but one of the most important is to ensure that those who have taken a training can translate that training to effective practice. What we know from the research is that child to staff interaction is one of the most important factors in improving child outcomes. Just because someone has attended a training, does not necessarily mean that they can effectively implement what they have learned,” said Koos.

“Our agencies offer technical assistance or, TA, on the phone and on-site,” said Koos. One area of TA that she particularly urged the committee to consider is business related technical assistance. “There has been so much focus on child development, which we can all agree is extremely important, we often fail to recognize that almost all child care programs are a small business. In 2012, we commissioned a study, “The Economic Role of Oklahoma’s Child Care Industry,” which found that the state’s 4,100 child care programs represented a network of small businesses, many of which are women owned and operated, that generate nearly $500 million in revenue and provide employment for about 20,500 workers with earnings of $290 million annually,” said Koos.

“Child care is a business. Business related technical assistance can assist child care providers with operating more efficiently and effectively. When you think about quality programs, please think as well, about the ability of child care programs not just to offer trained and competent staff, but also to use sound fiscal and management practices, which are the foundation to quality programs and essential to their sustainability,” said Koos.

Ms. Koos told policymakers that Oklahoma does not have a perfect system, but rather, a system with a stake in the ground for safety, accountability, and quality. “It’s been 17 years without reauthorization of CCDBG. We have the research on state policies. We know from the research what can be translated to best practice for child care safety and child development. I believe it’s time to provide some minimum protections for all our children and to ensure that public dollars are spent in an accountable way,” said Koos. She urged the Committee to take action to:

  • Improve safety protections for children. Require comprehensive background checks for child care providers and volunteers who care for unrelated children. Set minimum health and safety protections for all providers who care for CCDBG subsidized children.
  • Strengthen the Child Care Workforce. Require those who work in child care to have at least 30 hours of pre-service training and 24 hours of annual training. These are the recommendations from pediatric experts (see the National Resource Center for Health and Safety, Caring for Our Children recommendations).
  • Enhance Monitoring. Establish that programs accepting children whose care is paid for by CCDBG should have an inspection prior to licensure and at least once annually.
  • Improve Quality. Increase the quality set-aside for activities related to improving the quality of child care.
  • Subsidy Rates. Child care is expensive. It is hard for most families to afford; it is not merely a challenge for families in poverty. Consider a study by the National Academy of Sciences to review the cost of child care and recommend ways to design a better system.

Ms. Koos told policymakers, “I understand and support the need for state flexibility; however, at the same time, there needs to be some minimum core health and safety protections for all children in child care in our nation.”

Paula Koos with Subcommittee Chairman Rokita

Paula Koos with Subcommittee Chairman Rokita

To view the video of the hearing or the complete testimony of the witnesses, click here.
To view materials Paula submitted for the Committee record, click below:

On March 13, the Senate approved a CCDBG reauthorization bill requiring background checks for child care providers, important improvements to promote the health and safety of children in child care, as well as more accountable monitoring practices. The House is expected to draft similar legislation in the coming months. The House Education and the Workforce full Committee Chairman, Representative Kline, was in attendance at the hearing and spoke positively about the need to improve the quality of child care. This could be the year that Congress passes CCDBG legislation! Stay tuned!