State officials struck the right balance between safety and affordability with the pragmatic package of proposed day-care regulatory reforms released this week.
Among the smart changes to be pursued at the Legislature this session: increasing parents' online access to child-care providers' inspection records and requiring a physician's authorization before a licensed child-care provider can place an infant to sleep in any position other than the baby's back. Other sleep positions are a significant risk factor for sudden infant death syndrome (SIDS) and suffocation-related deaths.
But Minnesota families and providers are also well served at this point by what's not in the proposal from the state Department of Human Services (DHS).
The agency clearly considers safety improvements a public health imperative after an alarming increase in the number of children who have died in licensed family day cares in the state -- there were three in 2003 and 11 in 2011. But officials wisely stopped short of lowering the number of children these in-home providers can care for, a change that could have reduced already hard-to-find openings and driven up prices.
Minnesota's commercial day-care operators are some of the costliest in the nation, so parents here rely heavily on more affordable home day cares. Fewer in-home openings could price families out of licensed home child care and result in families relying on unlicensed caregivers who have minimal, if any, training or oversight. The point of these reforms is to increase kids' safety -- not slide backwards.
Reducing adult-to-child ratios shouldn't be ruled out permanently, but the reforms proposed this week should be given a chance to work before taking a step that would strain working families. State officials who decided to take a targeted approach are to be commended for heeding parents' and providers' concerns about tightening these ratios.
Suggested regulatory changes sensibly focus on promoting and enforcing "safe sleep" practices for infants in licensed family day cares. A report released by a state child-safety panel last year suggests that three-quarters of the deaths reported in Minnesota licensed family day cares involved babies who died in a sleep environment. A 2012 Star Tribune series found that infants who died in day cares were frequently put in their cribs on their stomachs or in cribs with overly fluffy bedding -- a suffocation risk.
Legislators should act quickly to pass and fund commonsense reforms to protect infants: increased safe-sleep training for providers, more regular checks on sleeping infants and fines for providers found in violation of safe sleep practices. Requiring a doctor's note for sleep positions other than the back is also critical; it not only will protect babies at day care, but it also sends a potent message to parents about safe sleep at home.
A 1990s national awareness campaign waged by pediatric health organizations likely played a role in a decline in infant sleep-related deaths during that time. But awareness faded, as Minnesota's sad statistics show. It's time for a next-generation campaign. Is there a public health-minded nonprofit willing to take on this important issue?
An editorial of the Star Tribune, Minneapolis.