2002_Annual_Child_Care

Department of Public Health: Consultative Services to Child Care Providers (2001)

The Legislative Program Review and Investigations Committee authorized a study of consultative services provided by the Department of Public Health to child care providers. The study focused on the department's compliance with C.G.S. Sec. 19a-82, which requires consultative services be provided to licensed child care providers throughout the state. The study evaluated the delivery of consultative services by DPH, the effectiveness of such services on the ability of child care providers to attain and maintain compliance with state regulations, and whether the services meet the technical assistance needs and demands of licensed child care providers.

As the study progressed, several areas needing increased attention became clear. Although state law requires DPH to provide "consultative services" to licensed providers to attain and maintain child care regulations, the department uses the term "technical assistance" to describe its efforts but has not adopted a formal working definition of technical assistance. Further, state law was silent regarding such services be provided to family day care providers. P.A. 02-26, originating from legislation developed by the program review committee, amended state law to require DPH to provide "technical assistance" to all providers, including family day care providers.

At the time of the study, DPH provided technical assistance to providers through a variety of methods, yet services lacked a centralized focus or master implementation plan. Services needed to be more fully communicated internally and externally, and better management analysis regarding overall performance needed to occur. There was no formal process in place to assess child care providers' needs for technical assistance or determine if technical assistance services were adequate to meet those needs. Also, specific training for licensing specialists, especially new specialists, regarding technical assistance was limited.

There was no formal oversight system in place to fully gauge whether the current "cross-training" program actually enhances delivery of technical assistance services, and written and dated policies and procedures relating to providing technical assistance are limited and need to be enhanced. According to a committee staff survey, 84 percent of providers surveyed said they had not received conflicting or inaccurate information from DPH child care staff regarding child care regulations. Although there were multiple efforts underway within DPH to ensure consistency in applying child care regulations, there did not seem to be a broad analysis of how well licensing specialists are implementing them.

The table below summarizes the recommendations made by the committee, the status as to how well the recommendations were complied with (i.e., full, partial, none) during 2002 (the first year of compliance by the committee), and key points from the agency response.


Summary of Compliance with Committee Recommendations
*Recommendation Summary*	*Status*	*Comments*
The Division of Community Based Regulation shall adopt a formal definition of technical assistance based on C.G.S. Sec. 19a-82. The division shall also ensure all child care regulatory staff and child care providers know and understand the definition.	Full	The Division of Community Based Regulation (DCBR) has adopted the definitions of "technical assistance" and "consultation" as defined by the National Association for Regulatory Administration Licensing Curriculum 2000. These definitions are widely accepted by the child care community. Licensing staff received training on the definitions in mid 2002 and providers received a mass mailing outlining the technical assistance services available from DPH.
The Division of Community Based Regulation shall take the following actions: · Develop clear and concise management objectives relating to technical assistance to child care providers. · Integrate the various technical assistance methods/services for child care providers currently used by the division into a formal implementation plan. · Develop a systematic approach to hold licensing specialists, supervisors, and managers accountable for carrying out the division's technical assistance objectives and providing the technical assistance services outlined in the implementation plan. · Communicate the management objectives, implementation plan, and performance measurement method(s) with each division manager, supervisor, and licensing specialist involved with child care technical assistance services. · Fully communicate the outcome of the plan development and implementation with the child care community, as identified by the division.	Partial	A comprehensive master technical assistance plan was developed by DCBR in early 2003. The plan was developed by a focus group representing a variety of early child care organizations and associations. A draft version of the plan was also presented to the Child Day Care Council and Healthy Child Care CT in mid-2002. The plan includes definitions, a policy statement regarding DPH technical assistance to child care providers, management objectives and goals, methods for providing technical assistance, staff training, data collection and reporting, and ways for assessing program needs. A systematic approach to hold staff accountable for implementing the plan has been developed, although it is unclear how often internal analysis will be done of technical assistance services for performance measurement purposes. In-service training has been provided to licensing specialists regarding technical assistance, although it is not clear whether the training included the DPH management objectives and goals. DPH included an article of its technical assistance services in widely-circulated newsletter published by the University of Connecticut's Cooperative Extension Service. An article describing the technical assistance plan is planned for the Spring 2003 publication.
The Division of Community Based Regulation shall develop a system to formally identify and assess the types of technical assistance desired or required by licensed child care providers.	Full	The department solicits feedback from providers in a variety of ways and conducts technical assistance workshops for providers. A database has been developed to track and summarize the division's technical assistance services and is used for assessment purposes.
Regular and thorough management analysis and performance measurement of the technical assistance services offered to child care providers through the Division of Community Based Regulation shall be conducted. Proper and adequate data regarding technical assistance services shall be collected, automated, and used for management analysis purposes.	Full	Technical service information is collected from various sources and tracked by the division's database. Management analysis of the technical assistance services includes review of that data.
The overall training program regarding technical assistance for child care licensing specialists needs to be formalized and enhanced based on specialists' needs.	Full	The division trained its child care licensing staff using the National Assoc. of Regulatory Administration curriculum in mid 2002. The division has also developed policies and procedures to address staffing, including training. The plan is to be reviewed every six months or as needed and adjusted to meet program need. Technical assistance is a regular agenda item on all Division Meeting agendas.
The Division of Community Based Regulation needs to develop a system to regularly monitor its staff training efforts to ensure such training enhances the effectiveness of technical assistance services to child care providers as required by C.G.S. Sec. 19a-82.	Full	The division uses technical assistance feedback forms, summary reports, and supervisory reviews of office and fieldwork to monitor staff training efforts and the effectiveness of technical assistance services.
The Division of Community Based Regulations shall make its interpretive guidelines for center-based and family day care home regulations available to the public on its website by March 1, 2002.	None	Draft interpretive guidelines were sent to the attorney general's office. The review indicated substantial revisions would be necessary. The division decided not to do the revisions, thus no interpretive guidelines have been completed. Regulations the division determines are difficult for providers to understand will be considered for revision, with the ultimate goal of revising child care regulations at a future date.
The Division of Community Based Regulation shall develop written and dated policies/procedures for internal use for providing technical assistance during each phase of the licensing and enforcement processes. The policies and procedures shall become part of the division's technical assistance master implementation plan.	Full	Policies and procedures for technical assistance have been incorporated into the division's master Technical Assistance Plan. A work group within the division is also in the process of developing procedures for each phase of the licensing and enforcement processes.
The Department of Public Health shall include a "Frequently Asked Questions" (FAQ) component on its Child Care Licensing Program webpage. Additional technical assistance information for child care providers, such as bilingual regulations, should be included on the website as determined by DPH.	Full	A "frequently asked questions" component for child care is now included on the department's website. The department's compliance response did not mention additional technical assistance information available on the department's website, such as bilingual regulations, although other child care material (e.g. licensing brochure) is drafted in English and Spanish.