1. What Does Research Say About Regulation of Early Learning? A Brief Review of Literature Regulatory Technical Assistance Committee Early Learning Council May 18, 2006

2. Workplan: Review research and seek input from parents, child care providers and licensors Develop principles and recommendations Organization of research summary: First: Research related to the principles for regulation the committee has discussed Second: Research on a few issues the committee hasn’t discussed directly Finally: Bibliography of the sources reviewed is in the back Draft principles: Review and edit Consider specific recommendations related to them

3. Committee principle: Regulation should promote safety

4. Bradley, 2004 Parents in Colorado, asked about what they thought licensing should do, talked about: –children and facility safety and –provider qualifications and background checks Currie and Hotz, 2001 Consistent finding that children have a lower rate of injury in child care centers where the director has a higher level of education. This requirement also increases the cost of child care Colbert, 2005 There are many direct causes of accidents and injuries, but the underlying causes are most often related to inadequate supervision and inadequate education and training of the provider Use data from monitoring, complaint investigation and accident reports will help show areas where existing rules should be strengthened. National data and benchmarks/standards can also be used. Link with expertise in injury prevention, such as Harberview Injury Prevention and Research Center in Seattle Annual monitoring visits help reduce injuries

5. Wrigley and Dreby, 2005 Looked at 18 years of national data on child injuries, fatalities and near misses in child care In general, child care is a relatively safe environment for children, when compared to in the community at large and in parental care. The incidence of injuries, fatalities and near misses is higher in licensed family child care homes than in child care centers. This seems to have to do with how work is organized in the two settings, rather than differences in the quality of care or among families choosing center versus family care In family child care, the provider typically works alone, and is responsible for everything over the course of a long day. In child care centers, providers work together, can often observe one another and get breaks In family child care, risk factors for injury include: –provider stress –lack of colleagues (no peers around) –breaks in vigilance and –an environment not entirely designed for children In child care centers, risk factors include: –diffusion of responsibility (“I thought you were watching him”) –trips away from the child care center, where the environment is much less controlled, and staff may not adjust their level of vigilance accordingly. One of the key components of improving safety in risky industries like aviation is a systemic process of reporting and analyzing accidents, and near misses, in a non-punitive fashion, to discern lessons. Medicine is also trying this. Could be something to consider in child care licensing

6. Committee principle: Regulation should promote good quality care

7. Gomby, et al, 1996 (and many other studies): Children prosper cognitively, emotionally, physically and socially in programs with : –fewer children per group or per adult staff member –caregivers who are sensitive and responsive to children –well-educated and well-paid staff, and with low staff turnover Morgan and LeMoine, 2004 Q: Do Licensing Rules Require Child Care Programs to Educate Children? A: Yes! Historical split: pre-schools educate and child care provides care. Now, 45 to 49 states show in the content of their licensing regulations requirement that child care programs offer an educational program of activities for children. The health and safety requirements tend to be more detailed than the educational requirements…but the educational requirements are there. For infants and toddlers, the ratio requirements are intended to foster the nurturing and attachment that are central to good quality. 22 states require a consistent caregiver through the day for infants. Pacing through the day, minimizing transitions and balancing between child and adult initiated activities are also addressed in many states Adult-child communication styles and efforts to promote language development also show up in regulations

8. Witte and Queralt, 2005 Study of child care center providers in Miami-Dade County, Florida Finding: It is possible to accurately estimate the quality of a child care program by considering six types of “readily available” administrative data. Using this data, it is possible to estimate quality just about as well as you would be able to do by adding in data from observations. Listed in relative order of importance, the data that can be used to predict quality are: –compliance with minimum standards –staff credentials (CDA, AA, BA) and use of curriculum –number and seriousness of complaints (noted by authors as usually reported by parents who provide “a different set of eyes”) –percent vacancies (noted by authors as meeting the market test, being able to attract parents) –presence of licensing sanctions –accreditation Programs in the study were inspected three or four times per year,

9. Committee principle: Regulation should include increased efforts to inform and involve parents

10. Bradley, 2004: Parents surveyed in three Colorado communities said they wanted to be given more information about how to interpret licensing reports. Koch, 2005: Recommends increased emphasis on consumer education Notes that states with strong licensing systems tend to see parents as part of the team and to provide parents with detailed information about licensing history of facilities and how to understand regulations Witte and Queralt, 2004 Research on two large counties in Florida One county placed child care inspection reports on the Internet, and publicized their availability Two results: Providers improved the center environment and management. Licensors produced more inspection reports and were more likely to provide mixed reviews of a center Did not seem to affect parent’s behavior, in terms of choosing one provider over another or leaving a program with bad reports.

11. Morgan: Child care licensing developed out of the child welfare system, where children do not have parents to look out for their best interest. Child care licensing systems have not been designed to have a strong role for parents Mendoza, et al, 2003: Both the Early Childhood Rating Scale and NAEYC accreditation standards recognize communication with parents as an indicator of a good quality program. Programs working with parents of young children should put a high priority on creating a culture of mutual trust.

12. Committee principle: Regulation should be respectful, and promote problem-solving and partnership/teamwork between licensor and provider

13. Koch, 2005: “…[G]ood licensors are teachers of standards; they take the time to explain the intent of regulations and how to achieve compliance. Skilled licensors consult with providers as they monitor; they take advantage of the “teachable moment” to reinforce regulations, especially as they see the provider struggling with an area of non- compliance.” (Koch, page 7) She also recommends: Provide more support for child care providers. Consider such things as warm lines, a two-part orientation, quality initiatives and self-study material Take a close look a licensing enforcement philosophy and get clarity about what licensing is trying to do

14. Gormley, 1999: Support is not at odds with regulating “While the degree of technical support varies from state to state…it is generally quite low and is not commonly regarded as an invaluable enforcement tool. As a direct consequence, relations between inspectors and providers tend to be more adversarial than they might otherwise be. Although one can imagine a situation where technical assistance became a substitute for, rather than a supplement to, meaningful regulation, that is not the case. Inspectors who offer technical assistance are actually more likely to perceive a given problem as serious and worthy of remedial action.” (pg 123)

15. Bradley, 2004 In a Colorado experiment different licensing models were tried, one of the three communities involved chose not to change any of the regulations – they focused solely on how licensing is done -- on providing more resources, support and monitoring. Colbert: Effective regulation requires buy-in from the regulated Morgan: “To be enforced, the standards need the support of the centers and homes that are asked to meet them. If there is not a significant strong group of providers of care, able and willing to meet the new standard, it cannot be enforced. However, the rules are changed about every 3-5 years, influenced by training, conferences, professional reading, accreditation, goals standards, and other influences…. Regulatory politics require some skill in uniting very different forms of auspices in a common commitment, but that is the only process that can bring about a higher level of quality through licensing”

16. Committee principle: Regulation should consider provider education and knowledge

17. AAP, 2002: All persons working in child care should be individually credentialed, by the licensing agency or a credentialing body recognized by the state. The credential should vary for different roles in child care, The credential should be based on age, education and experience requirements, as well as a criminal history background check Renewal and continuing education requirements An approach similar to credentialing of other professions, including teaching Two benefits: consumer protection and professional growth. Morgan: Licensing is focused on the facility in the legal sense, but on the provider for those standards that deal with qualifications, activities and interactions Gormley, 1999: Decreasing the number of children one adult can care for increases the cost of care and reduces supply – but this doesn’t happen so much when you increase provider education and training requirements. Given this, “the weakness of staff training requirements is both puzzling and unfortunate” (pg 122)

18. Committee principle: Regulation should be based on research

19. Fiene, 2002. Use of indicators, and weighting of regulations has been a part the literature on child care regulation since the 1980s. These indicators are common among licensing systems and based on research They have two values: The predict compliance with other licensing regulations and they predict good outcomes for children in care. Washington uses a monitoring tool based on these outcomes

20. The Fiene indicators are: Child Abuse Child abuse reporting and training requirements are followed Immunizations Children are up to date on required immunizations Ratios and Group Size Minimum adult to child ratios and maximum group size requirements are met Staff Qualifications Staff meet qualification requirements – education, background, references Staff Training Staff meet training requirements – pre-service, orientation, annual training Supervision Supervision requirements are met and rules for positive, developmentally appropriate discipline (child guidance) are followed. Fire Drills Fire, and other natural disaster, drills are conducted regularly, based on a written approved evacuation plan. Medications Rules for storing and dispensing medications are followed. Emergency Planning There is an adequate plan for handling emergencies – including maintenance of critical information for each child, parent contact and authorization for emergency care and a plan for back up care if the caregiver must accompany a child to medical care Outdoor Play Area Outdoor play areas are maintained in a safe condition Toxics Toxics are stored so children can’t get into them, and use of toxic materials is minimized Hand Washing Staff and children follow rules for how and when hands are washed and staff follow approved diapering procedures.

21. Colbert, 2005: Recommends: Commission a systematic comparison of Washington licensing standards with national benchmarks Reasons for rule changes should be documented and supported with data Data can also be used to identify areas where provider training is needed AAP, 2002 Good standards for regulatory policy come from: National Association of Regulatory Agencies (NARA) National Association for the Education of Young Children (NAEYC)

22. Committee principle: Regulation should be just and enforceable

23. Gormley, 1999: “…regulatory enforcement deserves as much attention as regulatory standards” (pg 116) Koch, 2005 Emphasize progressive enforcement, both positive and negative. Positive enforcement strategies include help at the beginning of licensure, training and resources. Negative strategies include fines and revocation of license. Morgan: Different enforcement strategies are needed for these three types of providers: –Newcomers: They need help and education on how to meet requirements –Forgetful licensees: The largest group, they intend to meet regulations, but sometimes get busy and don’t. They need a reminder from regulators that this must be a priority –Willful violators: A much smaller group, only fines or the threat of losing their license will change their behavior

24. Committee Principle: Regulation should be clear, consistent and reasonable

25. Koch, 2005 Provide more direction and support to licensors to increase consistency. Provide case consultation and similar supports for staff Upgrade the policy manual AAP, 2002 Regulations for child care should be –“Understandable to any reasonable citizen; –Specific enough that any person knows what is to be done and what is not to be done; –Enforceable, in that they are capable of measurement; –Consistent with new technical knowledge and changes in public views to offer necessary protection.” (pg 387)

26. Committee principle: Frequent monitoring is important

27. Koch, 2005 Cites a study of Vermont child care centers – those monitored more frequently performed better Even good child care facilities declined in compliance with regulations when monitoring decreased. Delaware increased monitoring and found that it was effective in increasing compliance with regulations. Recommends a workload analysis to see if Washington can do more monitoring. Other states with licensor caseloads (homes or centers per licensor) similar to Washington do more frequent inspections of child care sites. Colbert, 2005 Annual monitoring visits help reduce injuries. Research from other fields suggests moderate length inspections are more effective than either very short or very long ones.

28. Bradley, 2004 All three of the Colorado licensing pilot sites noted more frequent in- person visits as among the most helpful supports they received. (The focus of these visits was technical assistance, rather than monitoring) Witte and Queralt: The Miami-Dade study, from which comes the finding that the largest factor in assessing provider quality is compliance with standards, included unannounced monitoring visits at least three times a year GAO, 2004 Washington meets once a year standard, recommended by the American Academy of Pediatrics, for monitoring child care centers. However, it does not meet this standard for family child care homes which are visited once every 18 months

29. Proposed from research: Regulation must be comprehensive – covering most out-of-home care. Regulation must consider the impact of rules, not only the safety and quality of child care, but also on the supply and cost of care.

30. Gormley, 1999 “Children do not benefit from a regulatory regime so severe that it keeps providers under ground or prevents them from earning a decent wage…” (page 125) AAP, 2002 “Every state should have a statute that identifies the regulatory agency and mandates the licensing and regulation of all full-time and part-time out-of-home care of children, regardless of setting, except care provided by parents or legal guardians, grandparents, siblings, aunts, or uncles or when a family engages an individual to care solely for their children” (pg 383)

31. Proposed from Research: Regulation should make use of technology for effective and efficient regulation, including parent involvement

32. Koch, 2005 Recommends upgrading automation system GAO, 2004 Up-to-date technology is important for effective child care licensing Technology can be used to make licensing and enforcement information more readily available to providers and parents Florida is the state with the most complete, integrated, and up-to-date Internet-based technology [Unlike in most states, it was created especially for licensing] Florida created an online information system for providers and parents –Parents can use the system to access the compliance histories of each provider. –Providers can access regulations, training schedules, licensing inspection forms –This has helped providers increase professionalism and self-monitoring –Licensors spend less time answering questions. Some states provide laptop computers for inspectors. Licensors enter the results of licensing inspections directly, rather than having to complete a checklist manually and then enter it into a database on return to the office. A new licensing system can be independent or linked to other child care systems – subsidies, training, quality rating Technology systems are costly to develop and implement.

33. Proposed from research: Regulation should have a formal connection to the Quality Rating and Improvement System

34. Koch (2005) and Colbert (2005) : –Be active in the broader child care and early learning community. Good licensing doesn’t stand alone, but is linked to non-regulatory efforts to improve quality, such as QRIS and training. Colbert, 2005 From interview with Oklahoma: –A QRS system can encourage the maintenance of licensing standards by lowering the rating of a provider who goes out of compliance.

35. Proposed From Research: Just as regulatory standards are different in the home and center environment, effective strategies for ensuring family child care providers meet regulations may be different than those most appropriate for child care centers

36. Wrigley and Dreby, 2005 Risk factors for deaths, injuries and near-misses are different in child care centers and family child care homes. In family child care, provider stress, isolation from other adults, and lack of support and back up are risk factors that are significantly less prevalent in child care centers. Training and support for family child care providers should be increased Stuart, 2002 In some parts of the world, and to a lesser degree, in some parts of the U.S, some family child care providers are part of family child care networks. Providers receive services from the network such as referrals, billing and other administrative support, and substitutes. The network also typically provides some of the quality-building services associated with licensing such as monitoring, training and consultation.

37. Sources: American Academy of Pediatrics (AAP), American Public Health Association, National Resource Center for Health and Safety in Child Care, Caring for our children: National Health and Safety Performance Standards: Guidelines for out-of- home child care, 2002 Brandon, Rick, Child Care Licensing Review, Washington State Department of Social and Health Services, 1990. Bradley, Gini, “2004 Child Care Licensing Models Evaluation Report,” funded by Colorado Department of Education, Colorado Department of Human Services, U.S. Department of Health and Human Services, 2004. Colbert, Judith A., PhD, Early Care and Education Consultant and Licensing Training Specialist, “Minimizing Risks to Children in Licensed Child Care Settings: A Literature Review and State Survey”, for the Division of Child Care and Early Learning, DSHS, State of Washington, June 2005. Currie, Janet and V.Joseph Hotz, “Accidents Will Happen? Unintentional Childhood Injuries and the Effects of Child Care Regulations,” NBER and UCLA. November 2001 Fiene, Richard, Ph.D., “13 Indicators of Quality Child Care: Research Update,” Pennsylvana State University, National Resource Center for Health and Safety in Child Care, University of Colorado, 2002 GAO Report to Congress, “Child Care: States Have Undertaken a Variety of Quality Improvement Initiatives, But More Evaluations of Effectiveness are Needed” 2002 GAO Report to Congress, “CHILD CARE: State Efforts to Enforce Safety and Health Requirements,” 2004. Gomby, Deanna S., Nora Krantzler, Mary B. Larner, Carol S. Stevenson, Donna L. Terman, and Richard E. Behrman, “Financing Child Care: Analysis and Recommendations.” The Future of Children, VOLUME 6, NUMBER 2 - SUMMER/FALL 1996, Princeton-Brookings

38. Sources, continued Gormley, William, Jr., Regulating Child Care Quality,, Annals, AAPSS, 563, 1999. Koch, Pauline, “Report on Effective Legal Proceedings to Ensure Provider Compliance,” for Washington State Department of Social and Health Services, 2005. Mendoza, Jean, Katz, Lilian, Robertson, Anne, Rothenberg, Dianne, “Connecting with parents in the early years: Executive Summary,” Champaign: University of Illinois at Urbana-Champaign, Clearinghouse on Early Education and Parenting, 2003 Morgan, Gwen, “Regulatory Policy” Morgan, Gwen and Sarah LeMoine, “Do States Require Child Care Programs to Educate Children?” Reports #1 through #4: Clearinghouse on Early Education and Parenting. Discussion drafts, 2004. Stuart, Barbara, M. Sc., “Credentialing and Accreditation in Home Child Care: A Review of the Literature” The Centre for Families, Work and Well-Being, 2002 Witte, Anne Dryden and Magaly Queralt, “What Happens When Child Care Inspections and Complaints are Made Available on the Internet?”, National Bureau for Economic Research Working Paper N. 10227, January 2004 Witte, Anne Dryden, PhD and Magaly Queralt, PhD, “Assessing the Quality of Child Care Using Longitudinal, Administrative Data: What Can It Tell Us and How Can It Be Used? Part I: The Report,” Wellesley Child Care Research Partnership, June 2005. Wrigley, Julia and Joanna Dreby, “Fatalities and the Organization of Child Care in the United States, 1985-2003,” American Sociological Review, 2005, volume 70 (October 729-757). Many of these documents are available at: www.childcareresearch.orgwww.childcareresearch.org