Editor’s Note: Joanne Chiedi is the principal deputy inspector general for the U.S. Department of Health and Human Services. The views expressed are her own.
Joanne Chiedi: We have a lot of work to do to protect our children
All states should examine their child care requirements and oversight, she says
Every day, child care for thousands of American children occurs in places with substandard and unsafe conditions, too often with caretakers who have not passed background checks.
And the American taxpayer is footing the bill.
In 2015 alone, the U.S. government spent about $5.4 billion to help states, territories and tribes subsidize child care for low-income working families. Every month, the government’s Child Care and Development Fund underwrites the care of nearly 1.5 million children from low-income families so their parents can work or attend school.
Can families trust that child care providers receiving these subsidies offer a safe environment for children? Can taxpayers trust that their money underwrites only child care that meets adequate health and safety standards?
Unfortunately, the answer is no, as auditors from my agency, the Office of Inspector General for the U.S. Department of Health and Human Services, discovered: A stunning 96% of the child care providers we inspected in our unannounced site visits (218 of 227) had at least one health/safety violation – most often, multiple violations.
Starting in 2013, my agency released health and safety audit reports – including reports on child care in Florida, released last week – replete with details and photographs documenting hundreds of problems, ranging from worrisome to unhealthy and potentially hazardous. We also found 186 people who lacked a criminal records check either caring for children directly or present in the facility – in one case, living in the basement of a child care provider.
We have a lot of work to do to protect our children.
Our unannounced visits to home- and center-based child care providers in Florida, Arizona, Connecticut, Michigan, Maine, Louisiana, Pennsylvania, Minnesota, South Carolina and Puerto Rico uncovered the following unacceptable conditions:
In Michigan, some playgrounds had exposed rusty nails, dog feces and lawn tools within reach of children.
In Pennsylvania, auditors found a tree-trimming saw within reach of children. They also found that a provider had falsified information for her certification renewal to conceal pending criminal charges for corruption of minors and endangering the welfare of children.
In Connecticut, a child in home-based care called police. When the officers arrived, the authorized provider was backing up in her driveway, leaving to run errands. She had left the children in the charge of a woman sleeping in the basement, who did not have authority to care for them.
In Louisiana, auditors found a sharp knife accessible to children. Auditors also found understaffed facilities, including a center where a single staff member was responsible for 14 children, including babies and toddlers under the age of 2.
To be sure, not all sites had unsafe conditions, and nine child care providers passed inspections in every respect.
But the overwhelming number of problems uncovered make it clear that conditions for the subsidized care of low-income children need to change – and quickly.
Until recently, the federal government gave the money to states so long as each certified that it had certain minimal health and safety requirements designed to protect the health and safety of children. States received the money whether their health and safety requirements were strict or lenient.
In 2014, Congress mandated more rigorous health and safety requirements for child care providers receiving federal subsidies. The requirements include requiring CPR training, SIDS prevention planning and criminal background checks for staff.
Setting adequate standards is an important step, and effective oversight is necessary to ensure that providers comply. Child Care Aware of America, an organization advocating for quality child care standards, recommends that states employ one inspector for every 50 child care providers. Yet during our visits to the five states that reported their ratios, caseloads ranged from Connecticut’s 332 providers per site inspector to Pennsylvania’s 143 providers per inspector.
The 2014 law also authorized annual inspections for subsidized child care providers and established appropriate caseloads for inspectors.
The Administration for Children and Families in the Department of Health and Human Services must implement the law’s new requirements to the full extent of its authority.
All states should also examine their child care requirements and oversight and make improvements where needed, with the understanding that lax requirements and unsafe conditions risk jeopardizing federal tax dollars.
Our children are precious. They should not be cared for in places that have unsecured weapons, toxic chemicals and blocked fire escapes. And taxpayers neither want nor deserve to help pay for such dismal and unacceptable conditions.