Day care dilemma: New rules raise costs, complicate hiringBy DAVE SOLOMON
State House Bureau
June 17. 2017 8:55PM
CONCORD - An upcoming hearing before a legislative committee will be the last chance for day care operators and parents to make the case for or against new rules and regulations proposed by the Department of Health and Human Services that some say will raise the cost of day care and make it even harder to hire staff.
The proposed changes to the state's 104 pages of licensing rules encompass almost every aspect of day care operation, including training requirements and criminal background checks for staff, limits on screen time for children, evacuation planning and dealing with allergies.
"It was typically every eight years that they would revise the rules for day care providers, and it's moving to every 10 years," said Tracy Pond, program manager for Child Care Aware of New Hampshire, a child care resource and referral program based in Nashua.
The rules have to be occasionally updated, she said, to adapt to new technologies, new research and new perspectives on best practices.
"They are looking at national standards in terms of health and safety, and best practices to ensure that children are in healthy and safety environments in a group setting, which is very different from taking care of a child in your home," Pond said.
As initially proposed, the rule changes would have reduced maximum class sizes and student-teacher ratios, which would have had a dramatic effect on cost.
"We had one program in Manchester that would have had to close a classroom," Pond said. "You'd be trying to do more with less money coming in, and that's where it really impacts the businesses."
Current rules require one staff member per four infants.
The requirement for children ages 25 to 35 months is one staff member per every six children. Those remain unchanged, at least for now.
The proposed rule changes that have survived into the "draft final proposal" will have costs of their own, particularly a proposal to increase the required hours for continuing education from 18 to 24 hours per year.
"The national recommendations are 24 to 30 hours," said Pond. "It wasn't until 2008 that we moved from six hours and gradually moved it up over a period of years to 18."
Other proposed changes include requiring staff members to pay $50 every five years for an employment eligibility card that proves they completed the necessary criminal background checks.
In 104 pages of rules, you can find a lot of detail, even getting down to what kind of jewelry kids can wear and at what ages.
This requirement, for example, has been added to the section on Learning Materials Toys and Equipment: "Programs shall obtain parental permission for any child under the age of 6 to wear a necklace. No child shall wear a necklace during nap time or during sleep, unless the necklace is fused or has a fixed knot such that it cannot be removed, and the parental permission has approved of the child wearing the necklace even during nap time or during sleep."
According to DHHS spokesman Jake Leon, the new regulations now under consideration have been in the works since 2015, when the agency's Child Care Licensing Unit began working with child care providers and other stakeholders on revising the licensing rules, largely to comply with federal grant requirements.
"The department has sought to balance the needs of child care providers and their staffs with the requirements of a Federal Office of Child Care block grant that provides $16.5 million in funding in 2017 to help New Hampshire families afford child care," Leon said.
The proposal was revised after public hearings in April and earlier this month, with two public comment periods, the most recent concluding on June 13.
"The Child Care Licensing Unit anticipates incorporating additional comments into the proposed rule, consulting with the governor, and submitting the rule proposal to the Joint Legislative Committee on Administrative Rules," said Leon.
The Joint Legislative Committee on Administrative Rules next meets on July 20.
Costs a concern
While acknowledging that many of the rule changes have merit, Pond said they will invariably raise costs in a state that already has one of the highest costs for day care in the country with availability shrinking.
"It's going to impact either tuition rates, which puts it on the back of parents to support additional cost, or impact the staff, who will not get raises as a result," she said. "At the same time, the rules are designed to make sure kids are healthy and safe. We all want that. It's a tough balance."
Kitty LaRochelle, director of the Growing Years day care on Harvell Street in Manchester, agrees that some of the changes are necessary, but not all.
"A lot of the changes are going to put a cost on centers, which in turn become a cost for our families," she said. "Things like professional development. That's a perfect example. Twenty-four hours a year for someone working in child care is a lot when you look at other professional fields."
LaRochelle pointed out that day care staffers are not paid like school teachers, nor are they rewarded financially for continuing education in the same way.
Day care centers, like most employers, are having a very difficult time hiring right now, LaRochelle said, and the new regulations won't make it any easier.
"Qualified staff is the key, and that's where we are having a very difficult time," she said. "We have some fine staff members who take good care of children, but the qualifications we have to meet are putting a damper on who we can hire."
In the absence of extreme weather conditions such as excessive heat and humidity, cold temperatures including wind chill factors, or poor air quality that could affect the well-being or health of children as indicated in weather advisories issued by the national weather service, children shall go outside in accordance with the following:
(3) Children shall be monitored regularly for comfort in both hot and cold weather.
Sunscreen shall have UVB-ray and UVA-ray protection of SPF 15 or higher and shall be applied when the UV index is reported to be 3 or higher by the United States National Weather Service at least 30 minutes before sun exposure, every two hours, and after swimming, toweling off and sweating.
Screen time limitations
Television or other screen time is:
(1) Prohibited for children younger than 2 years of age in center-based programs and in family-based programs when cared for in a separate room away from older children.
(2) Limited to 120 minutes every two weeks for children age 2 years and older, and for children younger than 2 years of age in family-based programs when cared for in the same space as older children.
(3) Prohibited during regular meal and snack times, except for the occasional group activity such as watching a movie.
Programs shall develop and adhere to a written policy which shall be provided to parents at enrollment, and which at a minimum clearly states that:
(1) Expulsion and suspension may be used only as a last resort for children exhibiting persistent and extreme challenging behaviors; and
(2) Children’s persistent and extreme challenging behaviors shall be documented;
(3) Should expulsion of the child be determined necessary, parents shall be given no less than a 2-week notice to find alternate child care and shall be provided child care resource and referral information;
(4) If as a result of the persistent extreme challenging behaviors or a serious safety risk exists for the child or others in the program, the program may choose to immediately expel the child with the extreme challenging behaviors; and
(5) The program may choose to suspend the child for the remainder of the day if a persistent extreme challenging behavior poses a serious safety risk for the child or others in the program.
Allergy care plans
Each child with an allergy shall have a written care plan that includes at a minimum:
(1) Instructions regarding the food(s) or other allergens to which the child is allergic and steps to be taken to avoid them;
(2) A detailed treatment plan to be implemented in the event of an allergic reaction, including the names, doses, and methods of prompt administration of any medications; and
(3) Specific symptoms that would indicate the need to administer one or more medications.
Based on the child’s care plan and prior to caring for the child, child care personnel shall complete training as specified in He-C 4002.30(a)(5).
Each child’s allergies shall be posted prominently in the child’s classroom and wherever the child may come in contact with the allergen, with permission of the parent/guardian.
The program shall notify the parents immediately of any suspected allergic reactions, as well as the ingestion of or contact with a known allergen even if a reaction did not occur.
The marked-up draft of the new rules is available at https://goo.gl/jzfVLc.