Feds call for better child-care safety rules

WASHINGTON – Federal health officials issued broad new standards Thursday to improve safety in the nation's child-care facilities, triggered in part by news accounts of day-care deaths in Minnesota, Missouri and other states.

The proposals would apply to more than 500,000 child-care providers who receive federal subsidies, but are intended to raise minimum standards among all providers across the 50 states. Among the changes: better training to prevent infant sleep deaths, background checks on child-care workers and more tools to help parents identify subpar day cares.

Speaking at a District of Columbia child development center, Health and Human Services Secretary Kathleen Sebelius acknowledged that thousands of children lack access to quality care and credited journalism such as the Star Tribune's 2012 series on deaths at poorly regulated day-care homes for helping propel safety standards that she called "overdue." Thursday's proposal represents the first comprehensive federal effort at child care reform in 15 years.

"What's most troubling," she added, "are the gaps in safety."

Grace Reef of Child Care Aware of America, a national watchdog and advocacy group, called Thursday's announcement "very significant."

"We think it's the right thing to do — to review the regulatory authority and see how we better promote [the] health and safety of children," said Reef, policy chief at Child Care Aware.

In addition to training in safe-sleep practices, providers would have to know CPR, first aid, poison prevention and safe transportation techniques. Many providers in Minnesota already have to meet similar requirements — or will under reforms pending before the Legislature.

Too many children are "in unregulated, unmonitored care," Dunkley said.

He said 12 percent of children in Minnesota who receive the federal assistance funds attend unlicensed day cares, which have limited training and oversight.

"Too often the government is paying for unsafe care," he said.

The Star Tribune stories, published between March and December 2012, uncovered a spike in deaths at in-home day cares in recent years, with many incidents tied to unsafe sleep practices, overcrowded day cares and violations of basic safety guidelines.

In 2011, records showed, children were dying at a rate of roughly one per month.

The upturn in child care deaths in Minnesota had gone undetected in part because the state lacked any consistent reporting mechanism.

That, in turn, was part of a national pattern of spotty public reporting on child care deaths and serious injuries across the country.

As a result, no one knows how many children die in day cares each year, making it more difficult to spot trends and improve safety.

Sebelius shared the stage Thursday with Elly Lafkin, a Virginia woman whose 3-month-old baby died in the care of a woman who had hidden a criminal past by using aliases.

Such tragedies, Sebelius said, "finally provide momentum for stronger regulations and more safety standards. States have not stepped up to fill the gap."

Sebelius' proposal also calls for annual, unannounced day-care inspections. In Minnesota, inspections now generally occur every two years and, in many counties, in-home providers know their inspection dates because the inspector communicates with them in advance.

The new requirement will also make it easier for parents to review a provider's compliance history. It will include a hot line for parents to report problems and will require states to post inspection reports and other licensing data online. In Minnesota, inspection reports for in-home providers have not generally been posted online, making it difficult for parents to identify problem facilities. The state is taking steps to improve online records access, but the federal proposal would require all states to post such records on a user-friendly website for both in-home day cares and larger, center-based facilities.

The federal proposal was posted online Thursday and will undergo a 75-day public comment period. Officials could not say Thursday when the final rules would take effect.