State regulators want more training for providers, better compliance with rules.
An increasing number of deaths at Minnesota's in-home day cares prompted state regulators on Tuesday to call for more training of day-care providers and greater compliance with safe-sleeping requirements.
More recommendations are expected next month, as a result of a special review of child-care deaths undertaken by the state Department of Human Services in response to a Star Tribune investigation of safety violations and deaths in child care.
Deaths in licensed care have nearly doubled over the past five years, reaching a rate of nearly one per month. Many cases involved infants who were placed in unsafe sleeping arrangements -- on their stomachs, on soft beds, with soft toys that presented suffocation hazards, or combinations of those factors.
The state's child mortality review panel has long examined cases of sleeping infants dying unexpectedly in child care, but the newspaper's series drew its attention to the recent increase, said Erin Sullivan-Sutton, an assistant commissioner for the state Human Services Department.
"Many of these deaths are preventable, and we continue to see too many children die unnecessarily because they are in unsafe sleeping arrangements," she said.
Of 85 deaths in licensed child care in Minnesota since 2002, 82 have occurred in licensed home day cares, the Star Tribune found.
Nearly half resulted in sanctions by state and county inspectors against the day cares.
The mortality panel recommended that day-care providers retake training on safe-sleeping arrangements for infants every two years instead of the current requirement of every five years.
The panel also called for CPR training every two years instead of every three years, and hands-on training for certification instead of watching a video. The recommendation was made in part because of deaths in which child-care providers did not react appropriately and delayed calling 911.
None of these requirements was listed in the state panel's last report, in 2011.
Earlier this year, the state's inspector general for human services warned day-care providers that they would receive more stringent penalties in the future for any violations of safe-sleep standards, which include placing infants to sleep on their backs and placing them in cribs with fitted sheets and no heavy blankets or stuffed toys.
Sullivan-Sutton said the mortality panel's report on child-care deaths next month would examine issues beyond the current licensing standards.
The Star Tribune's review of child-care deaths found a significant number in which infants hadn't been checked on for long periods of time, including as long as three hours in one instance. Child-care experts generally recommend that providers check on sleeping infants every 15 minutes, but that isn't required of licensed family homes by the state.
Sullivan-Sutton said the panel will consider whether the state needs to tighten its standard of child-care supervision.