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Health, safety of children are motivating changes in child care regulations

Grand Rapids Herald-Review - 2/3/2018

New licensing requirements for licensed family child care providers (FCC) should improve the health and safety of children in care. As with any change, it can be hard and even disruptive.

Some of these changes include annual inspections, increased public and consumer information, including posting of annual inspections, changes to health and safety requirements, such as creating a health and safety plan and enhanced background studies for all providers.

According to a spokeswoman from Minnesota Department of Human Services (DHS), most of the changes the 2017 Legislative enacted for child care licensing requirements, which DHS is now implementing, were made to comply with federal requirements in the 2014 Child Care Development Block Grant Act to improve the health and safety of children served in licensed child care.

"They also make information on programs more easily accessible for the public and parents," the DHS spokeswoman said, whom asked to be unanimous.

Other provisions, such as a fix-it ticket, allow child care providers and county inspectors to work together to address minor issues identified during an inspection and avoid a more serious correction order while ensuring that child care programs meet safety requirements. Changes providing for amended correction orders and an expedited reconsideration processes for certain violations are intended to increase transparency and streamline the review and oversight process, the spokeswoman explained.

In response to providers' requests for more direct communication with DHS, representatives from DHS have been meeting with family child care providers and county licensing staff around the state to listen and learn from one another.

"Since August, we have held more than a dozen meetings across Minnesota, including recent meetings with providers in Duluth, Grand Rapids and Bemidji," the spokeswoman said. "The response has been very positive and we are receiving suggestions and insight that will help us collaborate with county inspectors and providers to clarify the most challenging rules and standards and ensure that children receive safe, quality child care."

Lori Petermeier, Itasca County Social Services Supervisor, said the January meeting where DHS explained some of these changes, was "very good."

"It allowed providers to have direct access to the DHS staff in order to clarify concerns regarding the changes," Petermeier said. "I am encouraged that DHS is doing these site visits as they are the first of their kind I have seen in many years."

Petermeier is in her 32nd year of working for Itasca County as a social worker.

Adopting the new changes

"Change is hard for most people in general," said Maureen Kangas, Itasca County Adult Foster Care/Family Child Care Licensor. "Changes can be disruptive; just when you thought you had your program in order along comes another change. The general theme with change since I have become family child care licensor is that requirements have increased. I can't begin to identify all of the changes that have happened prior to this latest change, although the last big one came in 2014 with increased training requirements along with decreased choice on how to meet those requirements."

"In addition to changes in licensing requirements, there have been multiple changes in licensing personnel over the past 10 years. I am the fourth licensor in that time frame and I hope to remain in the position until I retire. A change in licensors means a change in how licensing visits are done, what documentation is required to be submitted and possibly a change in policies and procedures. I know when I started as licensor I was told by my supervisor and by DHS-Licensing, that Itasca County needed to tighten up their variance policy with regards to capacity and age ratio. It was a difficult change for some of the providers," Kangas said. "When the wellbeing and safety of children are the main focus, I do not think we will see a decrease in regulations."

Kangas said she believes the emergency preparedness plans are necessary given the events that are occurring in communities just like ours.

"Flooding, intense storms, workplace and school violence, fire, gas leaks and other mechanical issues are all good reasons why we need to be prepared. Agencies in Itasca County are working together to make sure not only to have emergency preparedness plans in place but to also practice these plans to make sure that our community will be prepared if events happen," Kangas explained. "As a parent, I would be relieved to know that my child care provider is prepared and has communicated that plan to me. Instead of being reactive, providers will have a location in mind, supplies at hand and be working with local and county agencies to make sure that children are safe until they can be reunited with their parents."

She continued, "The snow storm earlier this week in Minneapolis was a great example of how being prepared pays off. When the snowstorm caused school buses to get stuck in the deep snow, children were left at school (sheltered in place) until parents or school buses could get through to transport children home. Kids were fed and enjoyed a variety of activities while they waited. Some kids did not leave until close to 10 p.m. but they were safe and well cared for in the meantime."

Kangas became the Adult Foster Care licensor in August 2009 and took on licensing for family child care in July of 2013.

Along with the emergency preparedness plan, comes the implementation of a more extensive emergency kit and Kangas explained that she thinks the emergency preparedness kit can be made with sheltering in place as well as evacuation in mind.

"If you are sheltering in place, a five gallon bucket located in the room that you will be going to makes sense. Instead of having the supplies in the bucket, you could have them in a backpack that you can grab as you move to where you need to go, whether that is to a location within the residence (where the bucket is already located) or evacuating the building altogether," Kangas said.

Every provider's emergency kit will be different, but should contain items needed in case of an emergency, such as a first aid kit, battery powered flashlight and radio, extra batteries, water, food, cash, admission and arrangement forms of children along with a photo of that child, toilet paper or even a few toys.

Enhanced background studies, NETSTUDY 2.0, will provide more safety for children in care, according to Kangas.

"Our current system relies on the person giving us accurate information in which to identify possible disqualifications," Kangas said. "NETSTUDY 2.0 will use fingerprints and have access to databases that are not currently being used. It is a more comprehensive search for background on that particular individual. The reason it needs to be redone every five years is based on an agreement that fingerprints would not be stored indefinitely but would be destroyed so they couldn't be used for any other purpose."

The enhanced background studies will come at a higher cost to the provider, as they have not had to pay for in the past.

"This cost will be used to cover all of the expenses DHS will incur when doing the background study. The added cost for the actual fingerprinting will cover the cost of the equipment and a fee to the vendor who is supplying the space, equipment and time to complete that portion of the process," Kangas said. "Having a process such as NETSTUDY 2.0 in place will ensure more safety for our children."

There are also changes to a child's admission and arrangements form and additional documentation needed if a child has known allergies.

"Again, the changes are related to increased safety and well-being for children in care. I know that there have been situations in Itasca County with children in care going into anaphylactic shock because they had an allergic reaction," Kangas said. "In one case the provider didn't recognize the child's response to the allergic reaction which was happening but luckily the parent (who was there to pick up the child) was present and knew what was going on. It seems like there are more allergic reactions in children and it's important that parents communicate with providers when this is the case."

Providers can also not deny access to a child with new legislation.

"Around the state there are providers who state specifically in their parent/policy handbook that a parent cannot pick up or drop off a child between certain hours of the day (generally naptime)," Kangas said. "I don't believe that this was something that was widespread in Itasca County. I know that some of the parent/policy handbooks asked parents to respect naptime but we're not going to deny access to their child."

According to Kangas, the other change that is causing quite a stir is the use of the Elici (electronic) checklist.

"It has given the licensor greater responsibility when doing a licensing visit. We need to identify whether or not the provider has met the requirement, not met the requirement, the licensor did not observe the requirement or the requirement is not applicable," said Kangas. "The licensors around the state have been working closely with DHS-Licensing to make the transition as smooth as possible. The Elici checklist will serve the function of identifying the outcome of a licensing visit. Once the licensor is done with the checklist a letter is sent to the provider. The letter will either say that no licensing violations have been found during the unannounced visit on such and such a day or it will generate a correction order outlining the violations. The outcome of the licensing visit will be published on a public site for all to see. It is meant to provide more information to parents about the provider."

Thoughts on the changes

Petermeier said through the years she has seen a number of changes in regard to DHS - most of which are a response to federal law changes and recommendations.

"Naturally, many have to do with the health, safety and stability of the families and clients we serve. A number have had to do with technology and automation of services in an effort for transparency," Petermeier said.

She added that she supports the recent changes that have come out of the 2014 Child Care Development Block Grant Act.

"I support the changes and feel that they are necessary and needed to help all 87 counties provide consistent response and automated licensing to our providers," Petermeier said.

Rita Craiglow, a licensed family child care provider for almost 26 years, operates her business out of a separate home.

"I have been through many changes throughout the years, along with four licensors. I have thoroughly enjoyed each of them; they have brought a wealth of information to my program," Craiglow said. "Some of the changes have been good, some not."

Craiglow explained it seems as if more and more pressure is being put on the family child care provider, with more regulations.

"Not all changes are bad, but it is becoming overwhelming regarding the service we offer and the businesses we are trying to run efficiently. I am all for safety and health measures to insure the best for our children," Craiglow said. "However, we have enrollment issues, significant limitations on variances, additional training requirements where certain areas must be met, difficulty finding subs and economic factors that affect how we run our programs. Because of our love for children that we choose to care for, many of us may have not health insurance, life insurance and/or retirement plans that employment in other fields may offer. There are just so many variables in the requirements for Licensed FCC Providers."

In addition Craiglow said, "We now have 'fix-it tickets' which is a very good thing, but it surprisingly even includes such things as a 'ticket' for toys that have cosmetic 'damage' such as a missing knob from a play kitchen set."

"When a provider is given a fix-it ticket, they are not eligible for another fix- it ticket on that item at the next re-licensing. It is like giving the provider a heads up so they can come into compliance without sacrificing safety," Kangas said.

In regard to the recent January meeting, Craiglow said she felt as if DHS did not have all the answers on what was required regarding the new requirements, as fingerprinting should take effect later this year.

"There is an overwhelming amount of paperwork that takes our time away from our responsibilities with the children. Many of us work into the evenings and weekends to fulfill these additional responsibilities, also attend more classes and workshops," Craiglow said. "We have our Minnesota Infant and Toddler Credentials, we are rated on Parent Aware, we have our CDA's, we belong to Child Care Associations. We have voluntarily taken the courses offered by First Children's Finance, we attend Saturday day-long workshops, we show up for community meetings regarding child care in our county. We are mentors; we are trainers."

When asked if she thought these changes would reduce the number of providers, Craiglow said, yes, she absolutely does. One issue is implementing the fingerprinting background check that has many agreeing it is valuable to have thorough background checks. Others, however, wonder about the validity and necessity of fingerprinting their own children ages 13 and up. It was stated during the recent DHS meeting in Grand Rapids, that even military and emergency responders fingerprinting records will not qualify for provider and/or family's fingerprint records and cannot be grandfathered in, so costs increase for larger size family's. There is a concern that these records will be destroyed every five years and must be repeated, but how and where does this happen? Providers and their families should have proof this has been done correctly, according to Craiglow.

"There are three providers that I know of that are going to be closing due to the additional rules and requirements implemented January 1," Craiglow said. "There are providers across the state that are taking early retirements, providers returning to school as non-traditional students to further their education in different fields, which further reduces the number of in-home providers."

Shauntel Clark, a newer provider running a licensed child care in Marcell, says she is glad for these changes.

"As a parent myself, I love the idea of a more extensive background check on the person taking care of my child everyday," Clark said. "I however completely disagree with some of the new requirements for the new emergency plan. I strongly think that some information should remain to provider and workers. It's for an emergency situation. What if the emergency is one of the family members."

Kangas said she completely understands provider's concerns [in regard to sharing the emergency plan with parents and/or guardians] if they are facing a domestic situation.

"It would be scary to know that the alleged perpetrator might have knowledge and therefore, access to the provider and the children. A good plan may incorporate locking down the residence, identifying a safe place in which children can be, and lastly, a call to law enforcement to intervene," Kangas said. "We all know that we can't plan for spontaneous incidents but being proactive about getting to a safe place is easier if you have thought the options through."

Craiglow added, "There are a few new providers just starting out in our county. Time will tell whether they can withstand all this."

Kangas said she is currently in the process of licensing five new providers. There are currently 66 family child care providers, five that are located in commercial buildings and 14 that are located in homes that are not the primary residence of the license holder.

For more information in regard to the new licensing regulations, visit the Minnesota DHS licensing website at https://mn.gov/dhs/. Providers who have questions about how to comply with a new requirement should contact their county licensor or reference the implementation plan found on the Minnesota DHS website. Comments and suggestions about the plan can be emailed to DHS at dhs.fccproviderquestions@state.mn.us.