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Transcript for audio podcast: State Regulations for License-Exempt Child Care Providers

From the Office of Inspector General of Department of Health and Human Services

[Brian Whitley] I'm Brian Whitley, Acting Regional Inspector General for the Office of Evaluation and Inspections in Kansas City. I'm speaking with Teresa Dailey, a program analyst in our office about an early alert memo entitled "License-Exempt Child Care Providers in the Child Care and Development Fund Program." Teresa, can you tell us a little bit about the Child Care and Development Fund, otherwise known as the CCDF program?

[Teresa Dailey] Sure, CCDF is a program run by the Administration for Children and Families, or ACF. ACF gives over $5 billion a year, to provide child care subsidies to working low-income families. Over 1 and half million children receive these subsidies every month. States also spend this money on quality improvement activities for child care.

[Brian Whitley] So, Teresa, why did you do a study on CCDF?

[Teresa Dailey] ACF was really concerned about health and safety in child care providers exempt from licensing. States use licensing to regulate health and safety for child care providers, but some child care providers are exempt from State licensing regulations. We did a State by State analysis of State regulation of license-exempt providers. We didn't look at health and safety in the providers themselves, but rather how States comply with Federal health and safety requirements.

[Brian Whitley] What are the Federal health and safety requirements?

[Teresa Dailey] States must have requirements in place for child care providers related to prevention and control of infectious disease, building and physical premises safety, and basic health and safety training.

[Brian Whitley] So, you looked at how States complied with these requirements. How did you go about doing that?

[Teresa Dailey] We asked all 50 States and Washington DC, how their providers were meeting these three requirements. We asked them to describe how they oversaw providers. We also wanted to know what kinds of providers were exempted from licensing.

[Brian Whitley] And what did you find out?

[Teresa Dailey] We found States exempt many different kinds of child care providers. We also found that some States had no requirements for license-exempt providers in at least one of the three areas, like health and safety training. Nine States did not have a health and safety training requirement for license-exempt providers. Twenty-three States allowed family home providers to meet building and physical premises safety requirements through self-reported compliance. However, we found monitoring was weak. In 29 States, license-exempt providers were not even required to report serious injuries.

[Brian Whitley] Why do you think so many States lacked basic health and safety and monitoring requirements for license-exempt providers?

[Teresa Dailey] That's a really good question. One reason is that the Federal requirements are very minimal. Some States don't allow Federal subsidies to go to license-exempt providers. States that do must have health and safety requirements, and monitor providers in the three areas. However, with no specific health and safety requirements, States are falling short and license-exempt child care providers are in a vulnerable position.

[Brian Whitley] It sounds like this study raises some major concerns, especially with license-exempt providers receiving Federal subsidies.

[Teresa Dailey] Yes, it does. We are encouraged that ACF proposed new regulations in May that would strengthen requirements for and oversight of CCDF providers, including license-exempt providers. The proposed regulations do not allow things like self-reported compliance with health and safety requirements, and they require States to take specific steps to monitor all CCDF providers. The proposed regulations include very specific minimum health and safety requirements for providers, like First Aid, CPR, and safe sleep practices training. Child care providers would also be required to report any serious injury or deaths of children occurring in child care to the State.

[Brian Whitley] Teresa Dailey, program analyst for the Office of Evaluation and Inspections. I want to thank you so much for sharing this important work.

[Teresa Dailey] Thank you.


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