Each year, tens of millions of dollars of federal money flow to Missouri to help low-income parents pay for child care.
And a fourth of the federal and state subsidies — or $38 million last year — goes to day care centers that are almost completely outside the bounds of state oversight and inspections.
In some cases, that money flows to places with dangerous and even deadly safety lapses.
Take, for example, a day care in north St. Louis that collected $36,000 in federal subsidies monthly, even though it was condemned by city building inspectors. Records show numerous fire and safety code violations, including a gas hot water heater retrofitted with an electric stovetop coil element powered by an extension cord.
Now, a bill awaiting Gov. Jay Nixon’s signature would trigger a landmark change in Missouri’s oversight of unregulated day cares that receive federal subsidies.
The proposed rules, negotiated up to the final hours of this year’s legislative session, would mandate state visits for the first time to unlicensed facilities that accept the money. The rules, approved amid federal pressure, would also require the development of quality indicators to give parents ways to evaluate the safety and caliber of the child cares.
“Having someone to be able to come into a home or a facility and assess and help improve quality — it’s going to change lives. It was a true win for kids,” said Erin Brower of the Alliance for Education, one of several groups that lobbied for the new standards.
The bill, SB869, is sponsored by Sen. Eric Schmitt, R-Glendale. It faced little opposition, given that the state was poised to lose more than $100 million in federal funding if it did not increase oversight by the fall of 2015 to comply with anticipated new federal standards.
The legislation is a victory for child care advocates, who cite a history of safety and quality concerns — such as the high rate of accidental infant sleep deaths at home day cares, previously documented by the Post-Dispatch.
Sen. Jolie Justus, D-Kansas City, who helped lead the push for the bill, said losing the federal subsidies would have been disastrous for the economy.
“It was imperative to me that we did whatever we could do to keep parents in the workplace while their kids were in quality, affordable day care,” she said.
The new monitoring would check for minimum health and safety standards. The visits would apply to all subsidy-receiving day cares, both licensed and unlicensed. That includes about 3,900 day cares in homes, churches and schools that are not inspected by state child care regulators. About 1,800 of those facilities are home day cares.
Missouri’s subsidy program uses state and federal funds and paid out $149 million to day cares in 2013.
Later this month, the federal Department of Health and Human Services’ Child Care and Development Fund is expected to finalize rules that demand more accountability of the child cares nationwide that accept $1.6 billion in federal funds.
The bill approved by the Missouri Legislature mirrors drafts of those federal rules. It represents a marked departure from Missouri’s otherwise light regulation of day cares based in homes, schools and churches.
Under the Missouri bill, day cares receiving state and federal subsidy money through the Department of Social Services would further be required to:
• Report serious injuries or deaths to the state to be kept in a publicly accessible registry.
• Have training for staff, likely to include CPR and infant sleep safety.
• Be part of a hotline reporting system.
• Participate in a new quality indicator system for parents.
The federal government had for years left it to the states to administer the subsidy money and develop their own standards on how it is distributed. For nearly 30 years, Missouri has allowed unlicensed child cares to receive it.
The new monitoring does not mean that day cares without a licence in Missouri must obtain one. According to the bill’s fiscal note, visits to unlicensed facilities would be conducted by the Children’s Division in the Department of Social Services, not by state child care licensing inspectors from the Department of Health and Senior Services.
State officials with the Department of Social Services, which administers the state and federal subsidies, declined to discuss the bill prior to its becoming law.
Last year, about $111 million of Missouri’s federal and state subsidies went to licensed facilities. The remaining $38 million went to unlicensed centers, with most — or about $25 million — spent at home day cares.
Critics have argued against increased state oversight in homes, schools and faith-based day cares, saying it constitutes a government intrusion.
But federal officials have made it clear that funding should be tied to strong regulations.
“We feel these are businesses, and they are doing this work for money, and this money is federal money,” Linda Smith of the Department of Health and Human Services said.
In arguing the need for new standards, federal officials have cited reporting by the Post-Dispatch in 2011 that documented deaths of 45 children, most of them in unlicensed Missouri home day cares, from 2007 through 2010. A review of many of those deaths revealed that most occurred in homes that lacked inspections and basic accident prevention standards.
At least three children have died in recent years in day cares receiving state subsidies, including a four-month-old who accidentally suffocated after a caregiver at a home day care in Ferguson fell asleep with him on a couch. State records show that that day care provider accepted, on average, $21,000 in subsidies annually from 2004 through 2011.
Under the bill approved by the Legislature, Missouri must develop a system to inform parents about quality, accountability and curriculum in the child cares. The mandate requires “input from statewide stakeholders such a parents, child care providers or administrators” to develop the indicators.
Previously, Missouri lawmakers have rejected a Quality Rating System, or QRS, that would use a star ranking system for child cares and tie higher funding to higher-ranking facilities. It was outlawed in Missouri 2012. An effort this session to lift the ban failed.