Meeting 11 Notes
October 24, 2008
Welcome to the Child Health Advisory Committee Meeting!
Note: Please contact Connie Satzler at (785) 587-0151 or csatzler@kansas.net with edits or corrections to the meeting notes.
Members: Mary Baskett, Dennis Cooley, Cindy D'Ercole (attending for Gary Brunk & Shannon Cotsoradis), Leadell Ediger, Paul Getto, Betsy Hineman, Vicki Hoffman, Gerard Lozada, Tom Ostrander (phone), Nick Rogers, Mary Ann Shorman
Staff: Sue Bowden, Mandy Cawby, Gary Kelly, Linda Kenney, Connie Satzler
Guests: Jim Redmon, Chris Ross-Baze, Rachel Berroth
*** Meeting Summary ***
I. Welcome and Introductions, led by Dennis Cooley
a. Committee Announcement: Paul Getto passed around the book Bullying Beyond the Schoolyard: Preventing and Responding to Cyberbullying by Sameer Hinduja and Justin Patchin.
II. Update on Early Childhood Mental Health Plan by Mary Baskett
a. Kansas has adopted an endorsement (credentialing) system based on one used by the State of Michigan. Now, are taking individuals through the endorsement process. There are 9 people currently endorsed at levels 3 and 4 (highest levels).
b. Working towards the ideal of having services available to children in their natural settings.
c. Early childhood mental health plan has been great starting point for building relationships and an early childhood system, which was an overall goal of the Kansas Early Childhood Comprehensive Systems (KECCS) Plan.
d. The Kansas Early Childhood Mental Health Advisory Council continues to meet quarterly and connect with the larger KECCS Plan.
III. Kansas Children’s Cabinet and Trust Fund by Jim Redmon.
a. Jim provided an overview and history of the organization. There are two parts:
i. Trust Fund, established in 1980 as a way to fund primary prevention of child abuse and neglect.
ii. Children’s Cabinet. Kansas decided to put tobacco settlement funds towards children’s programs.
b. Four responsibilities of Children’s Cabinet and Trust Fund:
i. Advising the Governor and the legislature regarding the uses of the moneys credited to the Children's Initiatives Fund.
ii. Evaluating programs which utilize Children's Initiatives Fund moneys.
iii. Assisting the Governor in developing and implementing a coordinated, comprehensive delivery system to serve children and families of Kansas.
iv. Supporting the prevention of child abuse and neglect through the Children's Trust Fund.
c. Cabinet is focusing on early childhood. Some initiatives include
i. Grant through HRSA funded the development of a comprehensive early childhood systems plan.
ii. Pre-K pilot projects.
iii. SmartStart Kansas: local grants to 47 counties.
iv. Early Childhood Block Grant
1. Received 36 proposals totaling about $35 million
2. Approximately $11 million is available
3. Review of grants is currently in-process
d. See the website for more information: http://www.kschildrenscabinet.org
IV. Child Care Licensing Regulations and the Child Care Systems Improvement Team findings by Chris Ross-Baze
a. BEST Team
i. “Best” Team Chartered by KDHE in the fall of 2007.
ii. BEST: Budget Efficiency Savings Teams. They were developed to address efficiency in government involving a facilitated process.
iii. There are many Best Teams in the state; the focus on this one is advising KDHE on improvements or changes needed in the child care licensing system and regulations.
b. Process
i. 10 listening tours across the state September through December 2007.
ii. Over 600 individuals gave comments during the tour.
iii. Hundreds of emails and letters received.
iv. Best Team used this feedback, as well as legislative and public testimony, research, Kansas data, best practice standards, and a review of other states’ regulations.
c. Priority Issues Identified by Best Team
i. Qualifications and Professional Development
ii. Inspection of Registered Family Day Care Homes
iii. Uniform Definitions Across Types of Care
iv. Age Groupings, Group Sizes and Ratios
d. Preliminary Recommendations: See presentation online for more detail.
e. Committee discussed findings and asked Chris follow-up questions. They hope to have the recommendations finalized by the time the legislative session starts and welcome comments and feedback at this time.
V. Child Care Death Data by Rachel Berroth
a. See information posted online:
i. Summary of Deaths in Kansas Child Care facilities handout
ii. Press releases
iii. Presentation
b. Rachel reviewed the definition of child care deaths, scenarios, and statistics.
c. The tracking and investigation procedures were reviewed.
d. Trends and patterns were reviewed.
i. 14 deaths in 2007 (12 infants)
ii. 5 deaths through September in 2008 (4 infants)
iii. Death more common in family care than in centers
iv. Highest number of deaths occurred in Registered homes (not inspected)
v. Sleep position, SIDS discussed.
e. Serious injury statistics reviewed.
f. See online information for more detail.
VI. Discussion Comments and Next Steps. Some of the related discussion comments included:
a. We need uncommon voices to come to the table (beyond the usual suspects) to let our legislators know how regulation keeps children in child care safe.
b. Committee should support safe environments while staying away from the specifics.
c. On the Committee’s behalf, Dr. Cooley will be a spokesperson for safe child care practices at the Joint Committee on Children’s Issues meeting in November or December.
*** Discussion Notes ***
Note: Discussion notes here include some of the comments made by members, speakers and guests. This is not a transcript of all comments. Although every effort was made to capture key comments accurately, some comments may have been misrepresented, and others were missed entirely. Send corrections to Connie Satzler at csatzler@kansas.net or (785) 587-0151.
I. Welcome and Introductions
II. Update on Early Childhood Mental Health Plan by Mary Baskett
Strategic plan focuses on: workforce development, access to mental health support and services, building system
Since last meeting…
- Endorsement system: Kansas has adopted from State of Michigan. Haven't had consistent credentialing for early childhood mental health. When some says they are a specialist in early childhood mental health, it hasn’t been clear what that means. The endorsement system creates clear credentialing and provides a way to control quality. We have purchased the system from Michigan and are tweaking and customizing for Kansas. We are taking professionals through the process. We now have 9 people who have endorsements at levels 3 and 4 (highest levels). This will continue. To get an endorsement, professionals are required to put together portfolio.
- Want services available to children in their natural settings. We got a start on this through grants a couple of years ago. We are supporting consultants to work in and with early learning settings. Block grants…
- Strategic plan - building a system. Following framework of broader early childhood plan, want mental health to be a component, better networking, better connections (state, local, multiple disciplines). The plan has been wonderful starting point for this type of relationship building. We went through process last year going out to local communities. Many local communities are identifying a similar approach. Identifying gaps, resources, what is needed.
- Advisory council will continue meeting quarterly, will continue to connect with larger early childhood plan.
Paul Getto: Were there discussions last time about challenges West of Salina? Has there been any specific follow-up or focus on that?
Mary Baskett: Absolutely right that there are challenges, lack of resources in Western Kansas, do have a number of relationships with universities, but workforce is a challenge in this area. Haven't specifically focused on Western KS yet.
Leadell Ediger: Strategies for workforce development?
Mary Baskett: Workforce is primarily addressed through endorsement.
* Committee Anouncment. Paul Getto: Had asked Dr. Cooley if I could have just a minute.
Book: Bullying Beyond the Schoolyard: Preventing and Responding to Cyberbullying. One of more comprehensive resources/research on bullying. Cyberbullying - related to mental health and is an emerging topic.
III. Kansas Children’s Cabinet and Trust Fund by Jim Redmon
History has 2 pieces:
1. Trust fund. Established in 1980 as a way to fund primary prevention of child abuse and neglect. KS was the first state to have such a trust fund. Now, there are 46 states. Many were modeled after Kansas. It is funded in a variety of ways. One is through marriage licenses, license plates, and sale of various items. All of the money goes to grants to communities to reduce child abuse and neglect. Primary prevention.
2. Children's cabinet. Kansas decided wanted to use tobacco settlement funds towards children's programs.
Four responsibilities:
(1) Advising the Governor and the legislature regarding the uses of the moneys credited to the Children's Initiatives Fund
(2) Evaluating programs which utilize Children's Initiatives Fund moneys
(3) Assisting the Governor in developing and implementing a coordinated, comprehensive delivery system to serve children and families of Kansas
(4) Supporting the prevention of child abuse and neglect through the Children's Trust Fund.
9 members.
The Cabinet has particular interest in early childhood.
Really believes in program accountability, evaluation. Higher level of scrutiny here than many.
Cabinet decided couldn't look at every single system that deals with children inKS. Decided to focus on early childhood.
Thanks to Linda Kenney, grant through HRSA, funded comprehensive early childhood systems plan. Attempt to bridge domains for early childhood. Has been fairly successful in having comprehensive way of talking about early childhood.
Cabinet's 3 areas for early childhood:
Incubator for new ideas in early childhood including...
1. Pre-K pilots - moved these on to Dept of Education for integration
2. SmartStart Kansas: local grants in 47 counties, actually more concentrated in Western Kansas.
3. Early Childhood Block Grant. Funded last year through an increase in the tobacco settlement. An additional $16 million went in, almost all went to early childhood. The Early Childhood block program is meant to look at high quality research programs, looking at kids that are at-risk (definition is broad). We want to drive funding towards evidence-based programs that are proven to work. We have received good proposals. It will be a hard decision to narrow down. 36 proposals were submitted - a few statewide and multi-county proposals. About $35 million in proposals; $11 million to spend. The block grant is a way of building a statewide system. We hope programs funded can be replicated across the state. Block grant: wanted to make sure it is comprehensive from ages 0-5 years. Asked to make sure there was set-aside to make sure at least 35% (I think) for the 0-3 population.
Dr. Cooley mentioned a meeting on the 13th, Kansas Early Childhood Comprehensive Systems Plan [KECCS] Stakeholders meeting. Head Start meeting is the same time.
Kansas Head Start pre-conference is on the 13th. Kansas Head Start Association Conference is on November 14th.
Mary Baskett: Brining in guest speaker, Brandon Williams from Choosy Kids on the 13th. Approach is to work with early learning staff on the I am Moving, I am Learning obesity prevention initiative.
Paul Getto: If you make this work, can we teach K-12 educators this approach?
Paul: Jim, sometimes people are hesitant about early childhood programs. They are afraid it will become mandatory. Have you made any progress here?
Jim Redmon: Think we have made progress, still dealing with some of those concerns. There is good research on brain development, etc. This has helped
Cindy D'Ercole: People no longer question brain development if they've heard the right presentation.
Jim: Frameworks was very helpful in developing message on early childhood learning.
Once have laid out the science and business applications, also have said, it's just the right thing to do. There's a moral reason.
IV. Child Care Licensing Regulations and the Child Care Systems Improvement Team findings by Chris Ross-Baze.
- Talking about basic standards of care that child care providers would need to meet.
- See presentation for more information.
- Best team stands for Budget Efficiency Savings Teams. Developed to address efficiency in government involving a facilitate process. Many BEST teams in state; this particular one has to do with child care systems.
- Received hundreds of comments on listening tour, and through letters and emails.
- Heard from many child care providers and centers that they are really struggling. Many pre-Ks are now attending public schools, so home providers and centers are seeing that 3, 4, and 5 year olds no longer in their care. They understand the early childhood research, but they are struggling to keep their doors open. They have asked the KDHE to look at more flexibility in provider/child ratios. That was a message we heard loud and clear.
- Also heard that we need to strengthen our professional development training.
- Research findings. Registered homes (not inspected) not as safe as Licensed homes, which are inspected. But finding that both are just basic. Don't have a lot of high quality care in Kansas. This information + information from Rachel's presentation put together a picture that we do need to strengthen quality of home care.
- Are looking at a number of best practice documents, neighboring states, states that rated high on licensing standards.
- Heard need for more infant care, more before & after school care
- See priority issues in presentation.
- Went through preliminary recommendations. Chris stressed these were PRELIMINARY.
- Recommending 16 hours of pre-service training for licensed, registered, and lead teachers in child care centers. (preliminary)
- Annual training - recommend increasing.
Paul Getto: Educationally, do you have the capacity to deliver this training?
Chris Ross-Baze: So far, delivered a training this week. Feedback was that pre-service requirements looked very appropriate. What we heard was where do we get it, and how can I afford it? We are going to go back to some groups that provide training and see if we have the capacity to provide this training now. Yes, we must have the capacity if we require it.
We need to hear feedback from rural areas, especially. We did our best, but felt like we needed to bring it back to everyone for feedback.
Struggle in the field to find the right balance..
We talked about a grandfather clause, but ended up using a sunset clause. Recommendation now is 3 years. It's actually very detailed, but didn't include all of the detail here.
In childcare, there is no requirement for high school or GED.
Inspection of registered family homes.
Providers wanted a 5-year-old to be considered school age, but this is not what the prelim recommendations say now.
Vicki: It is an economic issue. Providers have economic, sustainability concerns.
Chris explained some of the ratio issues and availability of infant care, including the current ratio requirements of centers vs. family care for center age groups.
When there is stress on a system, there is a tendency to look at the regulatory providers for relief of this stress.
They are looking at closing the doors because they can't support themselves anymore.
Vicki Hoffman: We see it from the other side. Teachers have their kids in day care. On teacher in service days, some teachers can't go to in services, because no childcare available for their kids.
Questions?
We are taking feedback back to BEST team. The team will make recommendations to Sec Bremby. Then, will be moving on to address other comments received in other areas.
Dennis Cooley: When will recommendations be finalized?
Chris Ross-Baze: We would love to have it done by the time the legislative session starts. I’m not sure if we will, but we are on a pretty fast track. Hope to have most of meetings done in November. It's a long process.
V. Child Care Death Data by Rachel Berroth
See presentation and handouts for detail.
Q: Wonder if with the self-reporting investigation, human nature is such that you 'fudge' a little. How do you take that into account?
Rachel Berroth: I think at the time of the investigation (2-3 days after death), information might start to change. We see a lot of inconsistencies between police and child care provider reports. Surveyors try to get to the bottom of the inconsistencies. However, we think, at the time, they are in shock and are telling the truth. Also, in a sense, they don't know certain practices are wrong (e.g., don't know you are supposed to check every 15-20 minutes). But, yes, self-reporting is an issue.
Surveyors have done a good job. These surveys are very difficult.
[Among infant deaths], about 20% of babies are dying in child care. Should be about 8-9% based on number of days and hours kids are in care. KS is not an outlier. It is similar in border states.
Think unaccustomed sleep position is part of it.
** Discussion
Leadell Ediger: Think we are really hoping that uncommon voices will come to the table to let our legislators know how regulation keeps children in child care safe. I think we could all be advocates for young children.
Think they need to have some unusual suspects come and talk about why regulations are important because they will definitely hear from the other side.
Joint Committee on Children's Issues will be addressing this in the November meeting.
Nick Rogers: Think this committee needs to stay away from the specifics, but I think we should support increased qualifications and efforts to inspect registered day care facilities. I think we need to support with they are doing, but not the specifics.
Dennis Cooley: Yes, think we can say - basically - that we support safe environments for kids.
Mary Baskett: Think some of this data would be very helpful for the group to hear.
Think there are meetings of the Joint Committee on Nov 10 and Dec 9.
It was suggested that Dr. Cooley would be a good spokesperson.
Dr. Cooley would be happy to do that if the Committee wants him to.
Write up main/generalized ideas, send out, make sure committee is okay with that. Then, he can use this and some of the data.
Leadell Ediger: Appreciate making that available to us. Great presentations, good for the committee to review and be involved in this.
Dennis Cooley: Thinking here in Topeka, most kids are staying with Grandma.
Great point. Thinking of my age, my peers; we were not taught to put kids on their stomachs. If 'grandma' does not hear how to do this, they will probably put them to sleep in their stomachs.
In light of economic times, even more important to strengthen the regulations.
Leadell Ediger: Yes, young children need basic health and safety issues addressed in child care.
Paul Getto: Even if we have the regulations, if we can't fund the inspection and training, it's not helpful.
Next Steps: Draft statement for Dr. Cooley to share with Joint Committee.
Next Meeting: Friday, January 23rd, 2009
| Meeting 11 Discussion Board is now closed.
|