Over a Dozen States Are Failing to Comply with Day Care Reporting Requirements
Originally published by The 19th.
Doubts swirled from the start.
After Cynthia King’s baby Wiley Muir died suddenly at a home-based day care in Honolulu, she fixated on the things that seemed off. The medical examiner said he died of pneumonia, but Wiley hadn’t been sick that morning. King wondered how sickness could take him so suddenly — how they could have missed that.
But most of all, there was the notebook, which King began keeping just four days earlier, when Wiley started at the day care. On the morning of February 6, 2014, King had jotted down what time her 4-month-old had woken up and what he’d eaten. That notebook had gone with Wiley to day care that morning and was returned to King at the police department days after his death.
The page she’d started the day he died was gone, ripped out. Instead, there was a new page rewritten in the day care owner’s handwriting.
“That freaked me out. Why on Earth, on the day he died, would the day care provider rip out the page and rewrite what I had already started writing?” King said.
A year and a half later, on what would have been Wiley’s second birthday, King and her husband ran into Therese Manu-Lee, the provider caring for Wiley when he died. She was wearing scrubs and appeared to be working with an elderly person. King wondered what happened to the day care.
Later, King looked her up online. The day care had been shut down by the state.
Right away, King called the Department of Human Services, which oversees the state’s child care office. Manu-Lee’s license was suspended while police investigated Wiley’s case but reinstated when the case was closed. It was shut down again a year later in 2015 when a surprise inspection of Manu-Lee’s home found her with 14 children in her care, eight of them infants — four times the legal number of infants for a home-based provider.
The doubts rushed back.
“That sort of overwhelming feeling of, ‘Oh my God, I knew she was lying to us about something, but I didn’t know what’” took over, King said.
That revelation set in motion years of battles: first with the police department to reopen Wiley’s case, and then with the state’s child care agency and the Hawaii legislature to push for new legislation that could make child care safer.
Beginning in 2016, King, an entomologist, sat on a Hawaii child care working group in the legislature and advocated for about a dozen regulation bills. But she could get only one new law through — an update requiring day cares to take on liability insurance. The Wiley Kaikou Muir Act passed in 2017.
Among King’s larger priorities was passing a law requiring Hawaii to post child care inspection violations online and track serious incidents, creating a window into the state’s child care safety efforts. But King was told at the time by state officials that Hawaii didn’t need that law — a child care safety movement at the federal level was about to do just that.
In 2014, the same year Wiley died, the country’s central funding mechanism for child care, the Child Care and Development Block Grant (CCDBG), was reauthorized by Congress with new requirements. CCDBG sends money to states to subsidize care for low-income children, and because every state takes CCDBG money, they all have to comply with its rules.
Until 2014, the block grant had paltry health and safety requirements. States didn’t have to run background checks on child care providers or collect data on deaths or serious incidents.
So no one knew, really, how many kids were getting hurt at child care across the country — how many were dying.
Although child care was and still is very safe, cases of children dying in day cares from preventable causes started to gain national attention in the early 2000s. That helped advocates launch what would become a nearly decade-long campaign in Congress to weave better health and safety guidelines into CCDBG.
New requirements passed into law with broad bipartisan support in 2014. Among them: For the first time, states would be required to start collecting and posting data around the numbers of deaths, serious injuries and substantiated abuse cases at day cares. Databases also needed to go online, allowing parents to search providers and see inspection reports and violations in their state. A series of federal, state and interstate background checks were also made mandatory. States had until October 2018 to come into compliance.
Ten years after those rules around health and safety were put in place, over a dozen states are failing to fulfill all the reporting requirements, an in-depth analysis from The 19th found.
After an inquiry from The 19th, the Office of Child Care, the federal regulatory agency that oversees states’ child care systems, confirmed that eight states are out of compliance. The 19th found an additional eight states that are missing data or have outdated information online. Six states updated their reports when The 19th pointed out errors or missing data.
In the process of reporting this story, The 19th reached out to more than 40 advocates, experts and organizations in the child care and child welfare space. Few knew anything about where the states stood on the reporting requirements in CCDBG. Some didn’t know about the requirements at all.
Linda Smith, a child care expert who was instrumental in getting the regulations passed, said states have been given too much latitude to comply. Neither the Office of the Inspector General for the Department of Health and Human Services nor the Government Accountability Office have audited the states to ensure they were following the reporting provisions, both offices confirmed.
“For the most part, they are sort of operating outside of the traditional system and accountability,” said Smith, now the director of the early childhood development initiative at the Bipartisan Policy Center, a nonpartisan think tank.
Systems like background checks and data tracking are key safety mechanisms in any industry. Food service inspection violations are posted online and in restaurants. Accidents with airlines are also posted online, even though, like in child care, they are also fairly rare.
Overall, the number of deaths at day cares is very low, often in the single digits annually in each state, and some states haven’t had any at all for the past several years. Among the 30 states and Washington, D.C., that published 2023 data, California had the highest number of deaths last year: 10; one child died at a child care center and nine died at in-home day cares. The two states with the next highest numbers last year were Texas at six deaths and Montana with five.
Data on injuries and abuse is murkier. States can decide how they define these cases — some count any instance that requires medical attention, others count only injuries that cause permanent damage — leading to widely different numbers. Georgia, for example, had zero serious injuries in 2022; Ohio, which also counts serious “incidents,” had nearly 19,000.
There is also no federal reporting requirement, meaning the data lives........
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