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This is the 16th article in a series investigating the child care system in Mississippi.

Mississippi plans to double the number of annual inspections of licensed child care centers, hire more officials to conduct inspections and ease the workload of current inspectors in an effort to improve the quality of care for the state’s youngest children. The Department of Health’s Division of Child Care Licensure has received an extra $1 million, a 50 percent increase in its budget, to enable licensing officials to inspect centers four times a year and allow them to spend more time helping each center to meet health and safety requirements.

Details of the proposal were shared by several sources who asked to remain anonymous because they were not authorized to announce these changes.

The director of health protection for the Mississippi Department of Health, Jim Craig, said in an emailed statement that “the funds will be used to expand and enhance the child care licensure program,” and said further details would be provided at a later date.

The changes in oversight coincide with an ambitious new plan from the State Early Childhood Advisory Council, or SECAC, to raise the quality of care for the state’s poorest children. Starting in 2017, Mississippi will give out additional government funds to child care centers that agree to meet new, more challenging state requirements.

Child care licensing
A child plays with toys at a northern Mississippi child care center. Centers will be able to borrow toys and materials from resource centers located at community colleges under the state’s new child care system. Credit: Jackie Mader

State officials are hopeful that their newest plans will improve a child care system that is often inadequate.

An 18-month investigation by The Hechinger Report and The Clarion-Ledger revealed a child care system plagued by a lack of funding and support. Although research has repeatedly demonstrated the early years are a critical time for brain development, few resources were directed to child care. Help for centers that have trouble meeting regulations, finding and keeping good employees and otherwise improving quality, was largely left up to a small group of organizations and nonprofits in the state. Legislative action on child care issues has been almost nonexistent. The state routinely received an F on the biannual rating of state child care program requirements and oversight policies performed by the nonprofit Child Care Aware.

A subset of child care centers still struggle to meet the basic health and safety rules enforced by the Mississippi Department of Health, and will need extra help to reach higher benchmarks.

Over the past 12 months, at least 213 child care centers — or 14 percent of centers in the state — were cited for violations that “may endanger children” in their facilities, according to information published over the course of the year by the health department. In at least 65 of these centers, children were left unattended.

Related: Child Care Crisis: State’s weak oversight puts children in harm’s way in Mississippi

In January, the department began including a list of centers that have broken some of the rules that are meant to keep children safe and healthy in its weekly “Public Health Report” email, as well as temporarily posting this information on its website. As of December 13, the department had reported at least 268 violations of “failure to maintain the minimum staff to child ratio, leaving children unattended, failure to conduct a background check, and lack of CPR/first aid training.”

The emailed lists mark the first time state information on whether child care centers meet regulations has been free and easily accessible to the public. Because the information was not widely available before, it’s difficult to compare the results to years past. Asked to comment on the number of violations, Jim Craig said in an emailed response that the findings “seem reasonable.”

Earlier this month, Gov. Phil Bryant praised the Health Department’s efforts at a meeting of the state’s early childhood council. “The Department of Health does a very good job with limited resources of making sure [children] are in a safe and hopefully healthy environment,” Bryant said. He also complimented the council’s plan to give additional funding to centers that meet standards for higher quality. The plan is slated to begin in July 2017.

The program would take advantage of a federal block grant to help low-income families afford care. Centers that wish to enroll students who receive federally funded child care certificates will be able to choose to be either “standard” or “comprehensive.” A standard center must meet licensing regulations and certain additional requirements, such as completing federally mandated training, adopting a curriculum aligned with the state’s early learning standards, and conducting an annual self-assessment.

Centers that wish to receive even more public funding per child can become “comprehensive” centers, but they must meet a bevy of requirements to do so, including conducting biannual assessments of children, using coaching to increase staff education and credentials, and developing a kindergarten transition plan.

The new plan replaces a voluntary quality rating system — Quality Stars — that will end December 31. That controversial rating system, run by a nonprofit agency that is closing after the state terminated its $16 million contract, enrolled 40 percent of the state’s child care centers and, like the early childhood council plan, linked federal child care certificate reimbursements to improvements in quality.

Child care licensing
A chart from SECAC’s new plan for child care quality shows the requirements centers must meet to receive additional state funding. Credit: Source: A Family-Based Unified and Integrated Early Childhood System

The soon-to-be-closed agency, known as the Early Years Network, also provided resources and training for child care centers. The state will replace this work with community college-based “early childhood academies” to train center employees. These academies will open mid-2017. Employees at child care centers whose licenses renew before mid-year will still need to complete the 15 hours of annual professional development training mandated by the health department. Many centers and advocates have expressed concern that options for free training courses will be limited in the six months before the early childhood academies open.

RelatedIs Mississippi’s child care system backsliding?

Unlike the Quality Stars rating plan, the new quality plan will not rate centers or offer tiered reimbursement for meeting aspects of quality, according to a state official. Instead, centers will receive more funding only after all quality requirements have been met.

The Early Years Network was shut down in part to save money, state officials said. They hope to find more cost-effective ways to deliver services. The state does not know how much its new plan will cost, according to Human Services Deputy Administrator Cathy Sykes, but she added that “all expenses will be paid” by the federal block grant money. Under the terms of the block grant, states are also required to spend a portion of funds to improve quality. The health department will receive $2 million from Human Services for licensure, up from $1 million previously.

“All children attending child care centers in Mississippi deserve high-quality care,” Gov. Bryant said in a statement. “Through the partnerships with the Mississippi Department of Employment Security, community colleges, universities and early childhood providers, this new plan maximizes resources and measures student outcomes to make sure our youngest children enter school ready to learn.”

“This is a real step back to the original intent: to make child care better for children.”

Experts say that large-scale quality improvements in child care are possible, but require significant investment in a sector where the pay is low and the educational requirements are minimal. “There’s this inherent tension between the quest for higher standards and higher quality and the resources centers have,” said Gerrit Westervelt, director of early childhood policy and resource development at WestEd, a San Francisco-based education research and service group. “Until we address issues of compensation and working conditions and support for early childhood teachers and directors, it’s really difficult to get the quality.”

He added that improving quality can take years, “but depending on the amount of resources available and the types of support that are available it can go a lot faster.”

More inspections

Licensing officials at Mississippi’s Department of Health are on the front lines, making sure children in the state’s more than 1,500 child care centers are well cared for and safe. Inspections of child care centers are often one of the only way parents and state officials can determine if a center is serving children well and what sort of support they need to fix problems.

In the past, the health department has struggled to recruit licensing officials and keep them on the job, resulting in heavy caseloads and less-experienced inspection staff. Currently, Mississippi’s officials each visit an average of 73 centers twice a year.

Four states and the Department of Defense assign inspectors to no more than 50 centers annually, according to Child Care Aware. Five states and the Department of Defense require the licensing agency to conduct quarterly inspections of child care centers. States that use block grant money to help fund child care are required by federal rules to conduct one annual inspection; Mississippi state statute mandates the same, although Department of Health officials said earlier this year that a policy of inspecting centers twice a year, except when short-staffed, was established in 1999.

Related: Who should fix problems with Mississippi’s early childhood system?

If Mississippi were to write into law its new policy of four inspections per year and decrease licensing officials’ caseload to 50 centers, it would join Tennessee and the Department of Defense as the only child care systems that meet both the caseload and inspection frequency benchmarks recommendations, according to the data from Child Care Aware.

Michelle McCready, chief of policy for Child Care Aware, said the nonprofit recommends states complete regular inspections, including some unannounced inspections, to ensure child care centers are in compliance with state requirements. “Given that children spend an average of 35 hours per week in child care, it is critical that child care settings promote both safety and healthy development,” McCready said in a written statement.

Leaving babies unattended

Child Care Aware also advocates for transparency in inspection results for the public. This month, Department officials announced they are moving forward with plans to put information from inspections for all centers online by July 1, 2017 and will make all inspection reports electronic when funding is received. (Under a recently reauthorized federal block grant, the state is required to post inspection results online in order to receive child care funding.)

The Hechinger Report has been collecting the temporary posts about center inspections in a database since January. This collection is available here.

Since December 2015, at least 27 centers were cited for violations of two of the five regulations most important for ensuring child safety, based on a single inspection by the health department; six centers were in violation of three of these regulations. Health department officials returned to at least 22 centers that had been fined for serious violations earlier in the year and cited them again for violating one of the five major regulations.

Officials reported at least 115 instances in which centers violated the minimum staff-to-child ratios, which specify, by the age of the child, how many children one caregiver can watch. Officials recorded more than 20 occasions on which there was no one on-site who was certified in First Aid or CPR, and at least 64 instances in which a center left children alone with staff members who had not cleared a background check.

Through a public records request, The Hechinger Report obtained additional records for seven centers that had multiple or repeated violations. All of these centers racked up hundreds of dollars in fines, based on a single visit, for problems like leaving one adult in charge of 12 infants and toddlers and leaving a group of babies and school-age children alone while workers took a smoke break outside.

Related: High turnover and low pay for employees may undermine the state’s child care system

Officials reported at least 115 instances in which centers violated the minimum staff-to-child ratios, more than 20 occasions on which there was no one on-site who was certified in First Aid or CPR, and at least 64 instances in which a center left children alone with staff members who had not cleared a background check.

One center, First Step to Learning Day Care, was fined $2,000 in one visit. In late August, the department received multiple reports of a child running towards the busy road outside the center. Three days later, on August 29, Health Department licensing officials arrived at the Jackson center to investigate the complaints. (Officials try to finish investigations within 10 days of receiving a complaint.)

According to Health Department records, an employee confirmed that the child had run outside. The employee told officials the child was enrolled in the center’s classroom for two-year-olds.

The August visit was the Health Department’s third to First Step to Learning in less than two months. In July, officials found a host of problems including electrical wires exposed in holes in the wall, diaper changing pads that needed replacement, and infant bottles that were not properly labeled with both the child’s name and the content expiration date. During a follow-up visit on August 3, a licensing official found that many of the “deficiencies cited during the inspection on 7/20/16 have been corrected.”

“Directors progress in bringing facility in compliance is appreciated,” the inspection record said.

But, during the August 29 visit to investigate the reports of the unattended child running outside, licensing officials found a series of new violations. Quarquerite Lowe, the director of First Step to Learning, denied some of the inspector’s findings to reporters. She said she agreed to pay the $2,000 fine, with money from savings, because she was told her license would not be renewed otherwise. “It was kind of a burden,” Lowe said, although she acknowledged fines do serve as a motivator.

“The fines make you get in order and get your stuff straight,” she said. “Because that’s money that comes out of your pocket.”

The Health Department returned for a technical assistance visit to the center on December 6 and a follow up on December 7, according to the health department.

Related: How to make improvements to Mississippi child care

Lowe said the center has taken steps to improve since August. She still deals with persistent challenges, like finding quality staff on short notice. The center recently hired a new staff member; Lowe said they make sure children are supervised at all times. Everything is now “properly up to date,” she said.

“We try to do the best we can with all the children,” Lowe added. “And sometimes things happen, and you know, when things happen … you just need to correct them … and make sure everything is going great.

Making child care better

The Hechinger Report’s investigation demonstrated that the threat of fines alone is not always sufficient to guarantee improvements. At least 20 centers in central Mississippi were repeatedly fined for violating one of the five regulations the health department has singled out as most important.

Child care licensing
Child care centers, like this one in Jackson, will be inspected four times a year beginning in 2017. Credit: Jackie Mader

When it discovers major violations, the health department can ask a center to temporarily shut down, or it can force a center to temporarily close its doors, as it did this year following an allegation of sexual abuse at a Northern Mississippi center. In recent years, the Health Department has asked several centers to close voluntarily. In an e-mailed statement, Jim Craig said voluntary closures are “in lieu of a ‘summary suspension’ of the license.”

Centers that are chronically out-of-compliance can improve, but first their problems must be diagnosed, according to Peter Mangione, co-director of WestEd’s Center for Child and Family Services.

“I would go find out what’s going on there,” he said. “Is it that they have so much turnover that they can’t keep staff up to speed on the regulations? Is it that there’s so few resources to work with they can’t afford to meet the requirements? You can’t really start to solve the problem until you understand it.”

Changes in the oversight of the child care sector may help the state do exactly that. The plan from the early childhood advisory council, in particular, calls for each center to create a personalized improvement plan if it wishes to receive the maximum amount of public money for enrolling low-income children. Such centers will receive regular visits from coaches to train teachers and directors.

Long-time child care advocate Jane Boykin, the former and founding president of the Mississippi Forum on Children & Families and former director of the state’s Office for Children & Youth, said the plan developed by the early childhood advisory council has the potential to improve child care in the state and create change. Early childhood education and child care “is a civil rights issue,” Boykin said, but for too long the state has lost focus of its original purpose in overseeing centers. “This is a real step back to the original intent: to make child care better for children.”

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