Minnesota child care proposal focuses on training, safe sleep

Legislation to improve the safety of child care in Minnesota is expected to pass the state Senate this week, including broader training requirements for in-home providers and stricter rules to prevent deaths among sleeping infants.

The legislation, however, lacks some key recommendations issued last year by a state infant mortality panel. The panel, which examined more than 80 day-care deaths, recommended more frequent inspections of day-care homes and lower ratios of children-to-provider — measures that some lawmakers deemed too costly for the state and onerous for day-care providers.

Broad new legislation was proposed by the Dayton administration this year following a Star Tribune investigative series that detailed safety breakdowns that led to a sharp spike in infant deaths across a system of 11,000 in-home providers in Minnesota.

"Overall, I think it takes some important steps," said Human Services Commissioner Lucinda Jesson, whose agency oversees child care regulation. "We need to continue to have that focus on safe sleep practices. The best way to do that going forward is through enhanced training."

Similar legislation in the House, approved Monday, was designed to balance the need for greater safety with the demands of in-home providers concerned that new regulations could raise their costs and threaten their businesses. Measures proposed by Gov. Mark Dayton that require extra state funding — such as five additional licensing staffers to increase training and support of county regulators — were stripped out because lawmakers would not commit the funds.

"It's disappointing because this is a big, important issue," said Rep. Tom Huntley, DFL-Duluth, who chairs the health and human services finance committee. "I think we should be doing more. This is a pretty straightforward thing."

Jesson said the issue is not fully settled. She plans to encourage lawmakers to fund the missing safety and training improvements when they enter House-Senate negotiations to reconcile the two bills.

The House and Senate proposals give the commissioner new authority to suspend the license of any day-care provider who violates safe sleep guidelines, and raises annual training requirements for in-home providers, to 16 hours from the current eight. They also require day-care providers to take training on safe sleep procedures every year vs. the current requirement of every five years. They also strengthen infant safety rules by requiring parents to furnish a doctor's note if they want their provider to depart from safe sleep practices, such as moving an infant to sleep on its tummy, which can increase risk of death.

Kathleen Fernbach, director of the Minnesota Sudden Infant Death Center, said she is hopeful the legislation will improve child-care safety, but said her group and other advocates will remain watchful. "At least we're going forward," said Fernbach, who was on last year's infant review panel. "If things are not improving, next session I think we'll be there talking about that."

An increase in training is a major step, one that advocates have been seeking for years, said Ann McCully, executive director of Child Care Aware of Minnesota. She was particularly enthused by the proposed addition of 10 hours of training in child development and behavior management before providers are licensed. Other states require more, but Minnesota currently requires none of this training as a licensing condition.

"If you're going to be taking care of young children for many hours of the day, you should have a fundamental understanding of … [child] growth and development and behavioral guidance," McCully said.

At large child care centers, which care for about 40 percent of Minnesota children in care, employees get about 40 hours of annual training, McCully said. The national arm of McCully's group, Child Care Aware of America, recently estimated that Minnesota has one county child care inspector for every 150 family child care homes — 10th worst in the nation.

Robert Fletcher, a Park Rapids father who was featured in the Star Tribune series, said he hopes the new law will spare other families the anguish he and his wife suffered when they lost their 3-month-old son, Blake. His day-care provider violated safe sleep guidelines by placing him face down for a nap and checked on him only once or twice over the course of 2½ hours. The family later learned that the provider had misled them about carrying insurance, when, in fact, her policy had expired months earlier. The current proposal requires more disclosure about insurance, but Fletcher wishes it had required insurance outright.

"I think it's great," Fletcher said. "Hopefully down the road there will be more changes. This is just phase one."