Monday, July 21, 2008

I know I'm going to get pooped on for this one....

OK, let's be clear at the start of this one: my children and now my grandson have always been cared for in one of the best licensed daycare facilities in the state--Limestone Hills Day School--because we work hard to be able to afford it.

Even so, I find the organization of a self-interested PAC by licensed day-care providers with the aim of shutting down their competition, to be downright ... well, I'd use the word "scary," but scare tactics is exactly what they're about here.

From an editorial in today's Snooze Journal:

Would you take your child to an unlicensed pediatrician? Would you put your child on a school bus with an unlicensed driver? What about your day care provider? Would you entrust your child all day to an unlicensed, potentially hazardous provider?...

There are about 1,300 independent licensed home day care providers now serving Delaware families. Licensed providers follow state regulations, take training classes and have their homes inspected each year. But there are also many homes -- no one knows the number -- where child care is offered by people who have no licenses and no training, and who are not inspected or regulated. Unlicensed facilities, headed by operators with uncertain backgrounds, can pose a threat to every child in these homes. Right now, the state is unable to shut down these dangerous facilities effectively. They are difficult to track down and, once found, difficult to enforce any sort of regulation upon.

Acknowledging that there is an issue here to be discussed, this editorial represents gratuitous fear-mongering of the worst sort, and Janet Nagengast, Sharon Strohm and Nancy Martin should be ashamed of the presentation.

Let's just start with the number of slick, unwarranted assumptions in the paragraph above:

1) Unlicensed day care providers "have no training." Really? How do you know? I know of several such providers who are LPNs and RNs, a standard of training that presumably exceeds that required for state licensed day-care providers. Whose responsibility is it to determine the acceptable level of training for the person who cares for your child, anyway? You, or the State? Will a State license make you entrust your child to somebody you inherently don't get a good vibe from?

2) Unlicensed day care providers are "not inspected or regulated." Beyond innuendo, where's the evidence that such inspection--beyond limiting the competition our authors face--is actually necessary or even a positive. Here's one example, provided to me by a licensed provider: State regulations are so contradictory that they often cannot be followed. Licensed providers are required to have a first-aid kit with certain items in it. One of the items required by one State agency in inspection is an anti-biotic ointment. But another State agency says you can't use that ointment on children. So the provider has to have a tube of that ointment in the first-aid kit, marked "do not use" in order to pass unannounced inspections. Yep, that State regulation is critical.

3) Unlicensed day care providers have "uncertain backgrounds," because they have not paid for background checks. Aside from the fact that public education proves every day across this country that background checks don't effectively screen out perverts and molesters, it raises a real question: who is responsible for deciding to whom I will entrust my children? I've known my next door neighbors for ten years--should I have a background check conducted by the State Police before I allow my children to be cared for in their house, for an hour, a day, or a week? You'll note what this article is short on: evidence of harm. While fear-mongering, all that the authors can come up with is a case from Texas, and not the slightest bit of evidence that the lack of background checks for unlicensed day care providers has caused any harm.

4) Unlicensed day care providers "pose a threat to every child in these homes." Really? What threat? What evidence? Tugging on my heart-strings is one thing, but let's get serious. I didn't bitch when the Catholic Church in the Diocese of Wilmington decided on its own to put all catechists and priests who work with children through background checks. There was a documented problem. Likewise, there have been documented problems in Delaware with foster parents, and changes in the regulations there. But to make the blanket accusation that unlicensed day care providers are a threat to every child they provide services for is a defamatory statement requiring evidence to back it up. And the authors have NOT provided any.

Ah, but we can't afford to wait for a problem, we're told:

That's why our group of licensed independent day care providers has organized a political action committee to effect change throughout the state and to protect Delaware's young. The Delaware Childcare Awareness Network has a mission to educate parents, the public and lawmakers. Our objective is clear: "Helping Providers, Protecting Children."

The state of Texas initiated a public awareness campaign to educate parents and caregivers after the tragic deaths of several children in unsafe unlicensed facilities. We don't want to wait for a tragedy in Delaware.

The Delaware Childcare Awareness Network is ready to partner with lawmakers, state agencies and parents to make changes and make sure Delaware kids in day care are as safe as they can possibly be

This is followed by a list of all the wonderful things that licensed providers can give you that unlicensed providers don't.

I say this (and it will be lost in translation, I'm sure): I have no problem with licensed providers organizing a public awareness campaign [which would otherwise be called a "marketing campaign"] to demonstrate their superiority.

Let's be real, however, and discuss what's really at stake here: restricting competition in the lucrative day care industry.

There are 1,300 licensed day care providers in the First State. There are probably just as many unlicensed providers, though i suspect the unlicensed providers tend to care for fewer children.

What happens if our legislature passes the restrictions that this PAC wants?

1) A considerable number of new bureaucrats, social workers, and enforcement agents will have to be hired.

2) Thousands of parents will lose their day care options or become criminal accessories overnight.

3) The cost of day care at licensed providers will sky-rocket (and its already outrageous in most cases). Even at the higher rates, there will not be sufficient capacity to meet the need, and thus....

4) Many working poor families will be forced to turn to elderly grandparents, sibling care, neighbors, or even quit their jobs in order to take care of their children.

On a moral and ethical level, this initiative raises another critical question: who is responsible, ultimately, for making the decision about where my children shall be cared for? Me, or the State?

(As a dead giveaway about the motivations of these folks, look at what they tout: licensed providers assist the State in reporting on whether your child gets regular physical exams and immunizations [they can turn you in]; they pay income tax on their fees [waa-waa, we hate the underground economy]; they qualify for Federal tax credits and matching funds from upscale corporate employers [which tells you what middle-class fears we're playing on here]; and my personal favorite, "Are you sure the "Uncle Charlie" at your day care isn't a sex offender?")

The reality, folks, is that unlicensed day care exists because it meets a critical need: affordable child care. Licensed child care is a great idea for those who believe that State certification is what matters in determining who should care for their children, and also for those who can afford to subsidize the higher costs of licensing that are inevitably passed on to the consumers.

If you don't want your child in an unlicensed facility, here's a thought: don't send the little tyke there.

But please stop the fear-mongering until you actually have some evidence to back it up.


Anonymous said...

OK Steve, consider yourself pooped upon.

I know the whole libertarian thing has you hatin' on all regulation because it limits your choice, but there are a number of things that I think licensing addresses.

For example, it may be difficult for you to properly assess the number of children enrolled in a daycare. This limits the ratio to a safe number.

Which brings me to the second issue, safety. Do you think that you have the wherewithal to assess fire safety? How about most people? A regular inspection of the daycare can uncover vulnerabilities in this area and ensure that the provider has a plan for emergencies and the staff to implement it.

I suspect that you would find that licensing restaurants is overburdening the restaurateur. But there are some things that one can only uncover with sufficient access. I would argue that this is one of those areas where State can and should provide a modicum of oversight.

Anonymous said...

I'll admit that in my case it's a hypothetical, as my GF and I haven't succeeded in doing the kid thing yet (not for lack of trying...)

However I would tend to suspect that the unlicensed providers are better known as "neighborhood moms" who are known to the parents, and have more of a reputation in the area than most "licensed" centers. Having seen my sister's kids at a major chain center, I'd FAR rather send my kids to an unlicensed neighbor that I know than some stranger with a bunch of papers from other strangers, mostly saying they have been trained to care for my kid in ways I might not want them to...

(Of course, there is a fair chance since we will be home schooling, w/ me as "Mr. Mom" that *I* might end up being said local unlicensed provider, at least some of the time...)


Steven H. Newton said...

That's not poop; that's just a little birdshit.

First off, there are two issues: one is the fear-mongering (which you stayed away from). The authors of this article made blatant claims about harm and safety without a single shred of evidence to back them up. At least in the arguments we've had over guns and such there are actual statistics of harm, etc., to dispute, argue. They have, in Al Mascitti's favorite term, created a straw man.

The provider to child ratio created by the State is, in fact, artificially high--I wouldn't send my child to a daycare that claims that to be the standard.

Now for your safety issues. Who do you think assesses the safety of my own house for my children, any house they visit, or the house of any babysitter I leave them with. Beyond bare code restrictions, that's right, me. (By the way, I am certified via military experience to do that kind of assessment, but I know that wasn't your point.)

You say, "A regular inspection of the daycare can uncover vulnerabilities in this area and ensure that the provider has a plan for emergencies and the staff to implement it."

I'll place the burden of proof on you there, since I can provide some countervailing evidence. Despite having requirements for regular safety inspections (and receiving the little gold plaques or whatever to prove it)), Delaware nursing homes are notorious for lacking evacuation plans, backup power plans, for meeting staffing requirements (think Delaware Psychiatric), or even conducting thorough inspections. In fact, when we were looking to place my wife's grandmother in such a home 2 years ago, virtually every independent out-of-state authority urged us NOT to accept the inspections by state authorities. Instead, they provided us with national standards and told us to do it ourselves.

I know from discussing this with dozens of day care providers that inspections by the state now are often cursory, variances are easy to come by (and never listed on the inspection certification), and that you cannot access the records of previous deficiencies without filing FOIA.

So I can make--with an absolutely straight face--the argument that such facility inspections in Delaware have been shown in comparable conditions to MISLEAD potential clients about the safety of the institution.

More to the point, have you ever examined a child care facility's license? I have. They provide almost no information of the type you speak of; establishments that just barely passed or require re-inspection because of major deficiencies get exactly the same certificate.

Licensing restaurants is a completely different subject, (and by the way I'm surprised you're trying that tired "you Libertarians" thing; I really thought you would engage on issues).

But since you brought it up, tell me this: approximately 15% of Delaware eating establishments have "B" sanitation ratings, which is only a few points above the State coming in to padlock the doors shut. Do you check for an up-to-date certification every time you sit down to eat? Can you honestly tell me that you would knowingly go to eat in an establishment that just barely avoided closure for poor food handling?

And yet, unless you personally check the certificates, how do you know?

This pretty much reduces your argument to: it's better than nothing and a reason to tighten up everything.

Fine: when you come back with some actual data we can discuss reasonable regulation.

But your fears, and the fears of the authors of that editorial, and the business people who started a PAC that will generate more business for them at higher prices, are NOT a legitimate reason to impugn unlicensed providers as potential sex offenders, or to suggest that people who use them are not actually exercising any oversight of their children's safety.

That's--and I will say it again--is fear-mongering in search of more business.

Anonymous said...

Steve, the "you libertarians" comment was ill-received. Not my intent, sorry. It was meant more as a commentary of "market-based" least-interference philosophy.

My children have been enrolled in 3 different home-daycares through the years. In addition, my sister-in-law owns a center. The centers are not my bag, so he have steered clear. I'll see what I can dig up on safety, etc. In the meantime, please note that DPC and licensing for seniors are distinct from each other and daycares, I know you know that, but there are many variations on inspections regimes.

I know that the daycare inspections system is under funded and its inspectors are often responsible for watching dozens of daycares. But I'm interested why you would attack the standards of inspection, rather than have interest in getting better inspections. It seems like an issue of making information available.

Restaurants are an excellent example. Have you been to the state's inspection site?

I wonder if there wouldn't be a way to make daycare information available through the same method?

Let me finally say something that is often not talked about. These daycare providers are often the subject of false reports. They are always dealing with a family's financial crises of some sort. Much more than most other service providers. I suspect because it is such a personal relationship, customers often feel they can take advantage of the "friendship" to slow pay or whatever. Unfortunately, I have seen these devolve into petty calls to the state to come do an inspection or whatever.

I swear, I could never do that job.

Steven H. Newton said...

Sitting here for reasons I can't go into, I've got just a couple minutes to respond, so if I screw it up try to read what you think I probably meant to say

"I know that the daycare inspections system is under funded and its inspectors are often responsible for watching dozens of daycares. But I'm interested why you would attack the standards of inspection, rather than have interest in getting better inspections. It seems like an issue of making information available."

I didn't attack the standards of inspection, per se, in the original post, but only as a response to your raising specific inspection standard related questions. In the original post I concentrated on the fear-mongering aspect and the lack of evidence.

But you raise a good point. I'm not at all against making information available; quite the opposite--I'm very much for it, but I don't think the government is necessarily the best way to do it in any kind of patient-care (kid-care) situation. Why?

Because the government invariably sets (a) pretty sweeping, inflexible standards [i.e. which ointments can or cannot be in a first aid kit]; (b) sends out under-trained, under-paid inspectors who don't actually advance in the system if they find something wrong; and (c) does not allow any competition from any other sort of inspection group.

Again, I'll do the nursing home example: which would you rather place your trust in? The piss-poor DE state inspection system or the one crafted by AARP that is much more detailed, flexible, and allows for individual feedback to be registered by relatives of the patients? I'd go with AARP--but the problem is that the government inspection is not interested in providing information that I can use to make informed decisions, but in using the force of law to determine which facilities stay open or closed.

If this PAC was all about creating standards, and educating parents into what they should be looking for and demanding in a child care facility I would support them wholeheartedly (as long as they dropped that fear-mongering approach).

However, what they also want to do, under the guise of saving our children, is to create a blanket system that allows the State to close down all their competition. That's industry self-interest lobbying pure and simple.

As for your comment on deadbeat parents stiffing the existing centers and then turning them in, I don't doubt that happens. It also happens that people put bugs in their soup when they don't want to pay for meals. As near as I can tell, however, the comment is neutral in terms of our current licensing discussion--it doesn't appear to advance your argument or mine--unless I'm missing something, and that's quite possible this even.

FYI I don't automatically reject government regulation, but I generally tend to see it as too often being applied in places it doesn't necessarily belong, and even more often stifling innovations that might improve things.

Or just costing us money.

Tell me, how many people do you think have ever used that V-chip we all have to pay to have in our TVs? Have you? Do you even know how to? said...

Thanks for your post, quite worthwhile material.