U.S. child-care rules getting tougher

Subsidized facilities targeted by HHS

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WASHINGTON -- After a growing number of high-profile media reports of children who have died or been injured in child care, the Department of Health and Human Services announced Thursday that it will, for the first time, impose tough national health and safety standards for all child-care facilities that accept government subsidies.

The proposed regulations will require workers in all subsidized child-care centers and homes to be trained in first-aid procedures, such as CPR, and safe sleeping practices. They call for universal background checks and fingerprinting of child-care workers. And they impose tough monitoring and inspection rules to ensure regulations are followed.

Although the new regulations apply only to the 513,000 child-care centers and family homes that accept subsidies for 1.6 million children who get them through the federal Child Care and Development Fund, HHS hopes non-subsidized centers will follow suit.

"We frankly can't wait any longer. Fifteen years have passed since we last updated our child-care rules" HHS Secretary Kathleen Sebelius said at Washington's CentroNia child-care center, "and we've had tragic stories of children lost and families devastated because there were no safety standards in place to protect them." The new regulations are "common sense" standards to protect children and give parents more information to make informed decisions, she said.

President Barack Obama, spurred by new science on how critical the early years are for brain development and by lagging academic achievement among economically disadvantaged children, has made early-childhood development a key policy for his second administration, pushing for millions to fund universal pre-K programs.

HHS officials said the administration is "adamant" about instituting new regulations.

The new regulations would supersede the current patchwork of health and safety standards that each state now sets, and that critics have long argued are too weak and endanger too many children. As many as 1 in 5 children who receive the child-care subsidy are in unlicensed and unregulated child-care settings, with no health and safety requirements at all.

"This is a huge deal," said Grace Reef, policy director for Child Care Aware of America, a child-care resource and referral network. "There have been so many tragedies. It's been 17 years since the law's been reauthorized. It's time we take a hard look and ask: 'What can we do to promote the health and safety of children?' "

The current federal health and standards are minimal. They require only that subsidized providers prevent and control the spread of infectious diseases, that the building and physical premises are safe and that providers have minimum health and safety training. Other than that, states have broad flexibility to set their own standards, and those are all over the map.

In South Dakota, a family home child-care provider can care for as many as 12 children without needing a license or meeting any standards. In Virginia, the number is five; in Maryland, one.

In California, child-care programs are inspected once every five years; but in Michigan, it's once every 10.

In Minnesota, a recent Pulitzer Prize-winning series recounted how children were dying at the rate of about one per week in family daycare homes.

The Child Care and Development Fund was last reauthorized by Congress in 1996, when it was consolidated with three other federal child-care programs for the very poor.

health - science


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