Child care collapse: ‘Punitive’ regulatory environment pushing providers out of the business

"Not only did it allow for both of my parents to work full-time jobs without having to worry about me, I also learned so many different things while there," the Hermantown High School senior said. "Cindy and her day care ... left a lasting mark on my life and will continue to for the rest of my life."

Future generations might not be able to say the same thing.

Minnesota has been rapidly losing family child care providers as an already difficult line of work is made unbearable by a hostile relationship between providers and the state and county agencies who license them.

"I'm just asking for the same respect someone would get at an office job," said Cindy Giuliani, who watched over Steven at her Piedmont home when he was young. "This climate of licensing right now has caused me to rethink whether I really want to be doing this for the next 15 years. And that's sad."

At the end of 2012, St. Louis County had 311 family child care providers. By the end of 2017, there were 230.

As providers leave the business, parents are left with fewer and often more-expensive choices when there is already a shortage of available child care spaces. Among those limited options, children may not get the experiences they need to help them succeed in school.

The Minnesota Legislature passed a number of new laws last year to ease the burden on family day cares and prevent the continued exodus of providers, but Giuliani said it's going to take a change in the culture, not the law.

"The only way we get new providers is by having providers who feel positive about what they're doing and would recommend you join that community. I just haven't been able to be that person for the past year."

Hopeful changes

It started in February with some bicycle wheels under a slide, right where they were supposed to be.

"They were tucked underneath the slide in my front yard so the kids could access them, because they do things like experiment with physics and roll them down the hill," Giuliani said.

It ended with the first correction orders she had received in 17 years of providing family child care.

On top of the 55-hour weeks, the need to pursue training and do paperwork outside of that window and the emotional heft of helping children grow, there's now a green letter posted at the entrance to Giuliani's home, where it will echo her faults until 2019. The Department of Human Services denied her appeals on the minor violations, which dealt mostly with record-keeping.

"More concerning to me is nothing was ever said at my licensing visit," she said about the bike tires being considered "rubbish" in a correction order.

That will have to change this year, because a month after Giuliani received her correction orders, other day care providers were telling the Legislature that they, too, were fed up with the status quo.

"I envision licensing and licensed child care providers working together, not punitively, but striving toward what matters most — the health and well-being of the little ones in our care," provider Barb Kyllo testified to the House Health and Human Services Committee in March.

That hasn't always been the case to date.

"Guilty until proven innocent," testified Julie Seidel, membership director of the Minnesota Association of Child Care Professionals, who added the regulatory environment is "burdensome and often unattainable ... and is discouraging providers from continuing child care."

A number of bills were passed to address those concerns. The law now requires exit interviews during annual licensing inspections — no more surprise violation notices — and makes some infractions eligible for a "fix-it ticket," as opposed to a more serious correction order.

County licensors also will be required to get additional training on licensing standards, with the goal of shifting from punitive to more constructive and educational licensing inspections.

Giuliani countered that's like "sending a bully at school to sensitivity training and expecting that because they have 90 minutes of training they're not going to go back and do what they did before."

The intention, at least, is there. After initially expressing concern over the fix-it ticket proposal, Department of Human Services Inspector General of Licensing Reggie Wagner testified it would go "a great way toward rebuilding that relationship and trust."

"When that relationship works, everything is golden," Wagner told legislators. "When that relationship is fraught, then it becomes a very difficult time."

A deep deficit

Any parents — from expectant mothers to longtime fathers — can tell you about the day care wait lists. About the stress of not knowing who is going to watch over their child. About wondering whether they both can go back to work.

"As a parent, I need to work. Our household can't function without both my income and my husband's income, so we both need to work," said Anna Tennis, who sends her girls to Giuliani for day care. "Without day care, it would likely be me that stayed home. This isn't abhorrent to me — it's just impossible. We'd be bankrupt."

Parents have long known this. Others are finally starting to notice.

A legislative task force found that Minnesota's child care landscape is "one with a rocky terrain of high costs for families; an ever-increasing shortage of providers that causes desperation in parents who seek to find care; and communities that are feeling the economic ripple effects caused by the shortage and high costs," according to a 2017 report.

The Northland Foundation, which supports child care in the region through provider training, scholarships and loans, is hearing about problems finding affordable child care from Duluth to International Falls to the North Shore.

"What is giving me hope and optimism is this has moved beyond an issue that families are facing," said Tony Sertich, president of the Northland Foundation. "I'm hearing just as much about the child care issue from economic developers, city leaders, small businesses and large businesses as I am from parents of kids and child care providers."

There's good reason for that. Northeastern Minnesota has the biggest per capita deficit of child care in the state, with 4,943 spaces needed and 8,876 licensed spaces available, according to a report from the Center for Rural Policy and Development. This can make it hard to attract and retain workers and adds to absenteeism at work — and it could keep parents out of the workforce at a time when unemployment is so low that employers are desperate for help.

Addressing the shortage here can't just mean opening more child care centers, the legislative task force found in its report, because rural areas often don't have the number of children needed for a center to stay afloat.

"A child care center needs a threshold number of children to make opening and sustaining a center feasible, a number harder to attain in Greater Minnesota," the report said.

Because of this, part of the solution has to be getting more family child care providers to join the industry and stay in business.

"Child care providers are transitioning from being considered glorified babysitters to being highly trained, dedicated professionals responsible for our future workforce and citizens," says the Center for Rural Policy and Development report. "Those providers, who are hanging on through these tough times, continuously improving their skills and excelling at their jobs, deserve to be treated as such."

More to be done

Children's lives are at stake. That's why regulations are tough, that's why the job is difficult, that's why parents need reassurances about whom they give their kids and money to.

"Licensing family child care providers helps protect the health and safety of children by requiring that certain minimum standards of care be met," the Department of Human Services says.

Providers agree that strict — though admittedly subjective — oversight is necessary, and a punitive regulatory environment is not the only reason providers are leaving the business and few are taking their place. Low pay, long hours, other careers offering more pay with less work and student debt can all keep people from starting or continuing day cares.

And if correction orders are driving providers out of the business, they are a way of life for other entities that DHS licenses. Just last week more than a dozen were issued around the state to home-based health care, foster care, adult day care and center-based child care providers.

It's different for family child care in that these "scarlet letters," as some called them in testimony, are placed at the front door of a provider's home, which DHS says is required "to ensure that enrolled families and prospective families are aware of a provider's compliance history."

Giuliani said why not require the orders be handed out to families, who can sign and acknowledge receipt, rather than embarrass providers for two years?

Other changes Giuliani would like to see are allowing anonymous feedback on licensors, and letting providers appeal violations to a separate entity. Currently, correction order appeals are made directly to DHS. Out of 277 appeals considered in the past five years, 68 percent of violations were upheld, DHS said, and only 10 percent were completely reversed.

"In terms of what providers experience," parent Anna Tennis said, "I can't imagine why people keep doing it."

New federal regulations are driving some of the less-popular changes at the state level, whether it's newly required fingerprinting for all household members for background checks, or the 2013 increase in annual training hours. Many of the recent state-led changes in the law, meanwhile, are meant to create "a team atmosphere between day care providers and licensing and oversight," said state Rep. Duane Quam, R-Byron, during testimony in March.

It will not be as easy as flipping a switch.

"We cannot even ask our questions if we are concerned about possibly making mistakes in the implementation of the new legislation or existing rules and whether we will be approached with disrespect and punitive actions," Giuliani said.

DHS has said it will support providers and has "instructed counties to provide technical assistance."

But the fear of retribution, of one wrong move and she's gone, made Giuliani afraid to even voice her concerns lest fines suddenly accompany her correction orders.

"It could cost me $1,400 to meet with you," she told this reporter. But she decided it's worth the risk to her career to make her industry a better place for providers and, in turn, children and parents.

Where are they going?

Family child care providers are leaving the industry much faster than they are joining it, prompting a statewide shortage of spaces for child care.

The Legislative Task Force on Access to Affordable Child Care said in its 2017 report that this is due to:

• Providers retiring
• Young, would-be providers choosing other careers
• Providers finding "more profitable and less demanding" work
• Tightening regulations and additional training and paperwork
• "Inconsistent and punitive" enforcement by county licensors

The Minnesota Department of Human Services in a 2016 report said not enough new programs are opening in part because "young families are less likely to purchase homes and are more likely to live in settings not as conducive to a family child care business" such as apartments or townhouses.

In 1995 about 24 percent of preschoolers with working mothers were in family child care, compared to 11 percent in 2011, which DHS said marked a shift in parental preferences.

But as goes supply, so goes demand.

"Closures peaked in 2013," DHS said in its report. "Anecdotally, the department heard from providers that both media focus on the risks associated with providing family child care and the resulting new regulations were sometimes contributors to providers leaving the field."

The department said that overall, less than 1 percent of day cares are closed due to license revocations.

New rules for family day care

Fix-it tickets

County licensors are now required to issue a "fix-it ticket" for violations that do not "imminently endanger the health, safety or rights" of children in family child care. These are items that can be addressed within 48 hours to avoid a correction order, which are posted at the front door of a provider's home. As of Jan. 1 there are 32 items the Department of Human Services has deemed eligible for the fix-it ticket as opposed to the more severe correction order, and DHS said it will work with providers to "review and update the list on an annual basis." Current items include a small hole in a screen, non-hazardous ripples in a rug, missing batteries in a flashlight, and "items that can easily be moved on the stairs."

Exit interviews

To prevent surprise correction orders or other negative actions taken against a day care provider, county licensors are now required to talk about any violations observed during an inspection — which are now annual and not every other year, per federal requirements. The licensors are also told to "offer technical assistance on how to comply with applicable laws and rules."

County licensor training

County licensors must take an additional training course, "The Basics Plus," and DHS will be assigning extra "licensing consultants for increased technical assistance" on a regional basis.

No quotas

Prohibits DHS or county agencies from "ordering, mandating, requiring or suggesting to any person responsible for licensing or inspecting family child care or child care center a quota for the issuance of correction orders."

Background checks

To comply with recent changes in federal rules, a background study conducted by the state that includes fingerprinting is now required for the provider and everyone residing in her or his household, including children older than 13. "All current and new child care providers will need to have a new background study meeting the above requirements," DHS says. "There is no 'grandfathering' of current individuals even if the previous study was conducted by DHS and used fingerprints."

Electronic Licensing Inspection Checklist Information

Known as the ELICI, county licensors will now be logging inspection data digitally to "allow the department to publish family child care inspection results, including the date of the inspection and violations determined," DHS said. That data will become available through https://licensinglookup.dhs.state.mn.us.

Source: Minnesota Department of Human Services