And I think that that's the last of the housekeeping bit. So again, my
name is Holly Wilcher, and I am with the Infant Toddler Specialist Network at the
State Capacity Building Center, and represent Region IV. All those States
down there in the southeast. And we're so glad to have you here today. To spend the
next hour with you discussing State strategies for building the supply of
your infant toddler quality care. And we know that research and data tells us
that the babies and toddlers out there, and they're families,
that the majority of the care there is average to poor. And so we're
really excited about all of the efforts and strategies that States and
Territories are employing to change those numbers and flip them on their head all
together. And we are delighted to have Rene Williams here on the webinar today.
And if you haven't met Rene from Maryland,
you need to pretty soon, because she's on fire for promising practices and
innovation and making sure that infants and toddlers, and families have
continuity of care and access to quality care. And I cannot wait for you to hear
her story and just a little bit about what she doing in Maryland to make sure
that babies and families have awesome early care and learning
experiences. So before we get started, just another reminder, if you can mute
your phones. We're going to start recording the webinar and we're so glad
your here. If you have any technical needs, please feel free to use the chat
room. And you can chat in there and everyone can see them, so if you have
questions for your peers too that's great. And here's how we're going to be
spending the next bit together, we are going to start off by identifying
ways that you use data to determine what kind of supply you have in your State
and Territory, and where are your shortages
with babies and care for babies and toddlers. We're gonna examine some of
your State supply building strategies, and some State supply building
strategies that are recommended by best practice. And then Rene is going to spend
some time with us telling us her story in Maryland. And we just love State
stories, and we love to share how it works.
So I know that you're going to enjoy hearing her story here today. And then
we're going to transition into, we can't do any of this without checking and
making sure that what we're doing, that we know what works well about what we're
trying. And what we might want to tweak and that continuous quality
improvement process. So we're gonna look at some resources and State strategies
for how to measure our progress towards our supply building to see if we're
doing it well. This webinar full of resources
and references and we are not going to go through all those, because you can go
through that on your own. We will spend most of our time discussing with you and
Renee her example in Maryland. But we're going to make sure that we
reference those for you so you know where to find them later on the webinar.
So you can follow up, exploring some strategies, you can access
those via the webinar. Another reminder to mute your phone, if you
haven't done that already. And encouragement to use the chat box, and
we'll go ahead and get started. So I'm not going to repeat these, but here are
your learning objectives. As a result to spending our next hour together, we hope
that you're able to do these things listed on this slide here. And before we
move in to the state strategies portion and look at our data to inform our
decision-making, I just wanted to focus on this slide for a little bit because
we believe that it really does set the tone for why we are focusing on this
topic in general. And when the Child Care and Development Block Grant was
reauthorized, Congress added some new purposes to this Act
that includes a couple more provisions
related to specifically building the supply, not just care, but quality care.
And so right here you'll see where we're going to focus, where this red arrow.
Because the Act increased the share of funds that you, as Lead Agencies, are
required to spend on quality activities. Increasing that minimum, that was
previously a four percent requirement, to nine percent over five years. And more
over, authorizing that at least three percent be designated
specifically to improving quality care for babies and toddlers. So that is
a significant kind of direction and our call to action here for why
we can focus on specifically these supply building
strategies that are effective for, not just children birth through school age,
but specifically infants and toddlers. That, paired with the data that
we know, that the care that there is right now is on average
poor to mediocre quality care. In two constructs that we just want to make
sure we operationalize before we begin, in terms of what we're talking
about, when we say supply and what we talk about when we say quality. And
this first slide focuses on supply. So we really want to stress that the issue
of quality/supply for infant and toddlers means, not just that we have a quality rating
improvement system and that folks are participating in it, but it means that we
have enough slots to serve infants and toddlers. And that that
supply is spread out geographically so that it's available to families with
infants and toddlers where they live, close to where they work, and also available at
hours that services are needed by families. And that it's affordable
and meets the the standards of care. So that's a very loaded definition of
supply, and we want to make sure that we're on the same page when we talk
about supply. Not just about the one to one correspondence. It's about all
of those other factors as well.
The next concept that we want to make sure that we operationalize, before
we move forward so we're on the same page, is this concept of quality. And
we could spend a series of 10 webinars talking about quality, but
we want to talk about quality in terms of the structural process variables,
and the measures and markers. And you all are familiar with quality rating
and improvement systems or your State's quality frameworks that you have to
measure quality, In addition, we have Head Start Standards and
we have the six essential practices for the program for
infant/toddler care. There are so many options for measuring quality and infant
toddler care, and then we have these markers that we're looking for.
These are our 'go to', true north markers for quality. There's adult-child interactions.
The quality of environment. You want to make sure that when we talk about this
construct of quality, that again means, enough supply and that the
quality is used by a measure that is widely recognized and accepted as
best practice in infant/toddler care. And we looked at all the States, and
y'all are doing amazing work in framing your quality approaches
to measuring infant/toddler care. So thanks for letting us set the
stage really quickly for those two constructs. And before we make decisions
about infant/toddler supply building strategies, we have to ask ourselves
certain questions to make data informed decisions. And we want to
identify what does our supply look like? Where are families with low
incomes or who live in poverty and need these supplies and subsidies or vouchers?
Where are CCDF providers located and where are the
quality pockets? And the gaps in quality, for both providers who participate in
Child Care and Development Fund and those who don't.
And finally we also want to make sure that our data looks at where
are the families? Where are their jobs? If there's a great pocket of quality, but
there are no families living there then we make different decisions based
on that data. And then the next conversation that we have is about
using that data to inform our decisions. And one of the things
that we know is that some States have used different means to collect their
data. And this is an example right here of New Jersey.
They used a survey to examine the availability of their child care and
to understand the availability, specifically of their center base. They
conducted this questionnaire on the available slots that they had compared
to the number of children likely to need care with all of the parents at work.
To get a front line view, New Jersey conducted a focus group and they held
it for directors and centers to discuss the challenges and supports needed to
provide high quality care for infants and toddlers. So this is just one
strategy that a State used and you can check out their report here, but we want
to hear from you for a little bit. And we want to know what, how does your
State gather information about the supply of infant/toddler care in your
area? So in just a second you're going to see your screen change and a poll
is going to come up here for you. And we want you to tell us. You can check all of
the options that are applied, but what are some of the ways that you make your
data informed decisions about your supply building strategies? And I thank
you so much. I hope you can see the results populating. Looks like you all
are engaging a lot of your child care partners. If there are ways that you
collect data on the supply of your care go and they're not listed here please do
type them in the chat box so we can learn from each other right and then put
your state in parenthesis so we can know which state is employing that
innovative strategy. I'm just going to give you a couple more seconds to
participate in this I know Renee is going to talk a little bit later about
how they established their understanding about their spots, okay.
Wow a lot of your collaborating with your childcare resource and referral agencies
your partners who have their finger on the pulse and understanding and then
Maureen thinks you've got Child Care Aware of America mapping project fantastic,
thanks so much for sharing. A lot of you use quality framework
or your quality rating and improvement system. Well everybody has selected
one of the most usual suspects ways to collect data so thanks for sharing that.
I see the most popular of course is child care resource and referral and
then the Quality Framework or QRIS. Thanks everybody for participating in
that poll. That was really helpful data and continue to chart those ideas
of other ways to get your data in the chat box so we can all learn.
So this slide just shows the myriad of choices they all selected, you know
there's any number of creative ways right to get the information that we use
to make decisions about what our supply is and making those data
inform decisions is super important because otherwise we're shooting a
target in the dark right, about what we need. The next thing that you may
consider is how to determine that true cost of quality and this slide just
talks a little bit about some of the means to get at that true cost of
quality so some of you have used the provider cost of quality calculator it's
a tool that's available to you it's linked further down on this webinar
slide on this webinar slide presentation, and you can estimate the true cost of
quality for how you want to reimburse your infant toddler providers
for versus your preschool etcetera. And all of the factors that you can think about
in helping programs to determine the
true cost of quality. You can also get provider rates from subsidy programs
looking at you know average wage and families of ability to pay and
what we know is that it's comparing that actual cost of the ability to gain
subsidies, parent fees, and other sources of funding factored into the
real picture of what kind of gaps between quality and the cost, so there's
there's tons of factors that we want to consider. And those those cost of quality
and we know right that one of the highest costs is that personnel cost and
that's a huge driver the childcare budget specifically in there's infant
toddler rooms. So the cost of quality calculator can help you out with that too,
and if you if you have other ways that you determine the cost of quality
in you states we'd love to hear about it in the chat room so please do or if
you've got an experience with the calculator and you've used it please do
share it with your peers in the chat room. So the next slide
we've just summarized kind of making those data-driven to informed decisions
and making sure that we've got the cost of quality and we've got some state and
national resources further down linked in the PowerPoint where you can look at
how states have used the cost of quality and reports on that. So be sure to check
those out after you download the webinar. And the next little bit we're going to
jump in is looking at strategies, right, to build the supply of high quality
infant toddler care, and so right here you've got a bunch of official list of
kind of ideas that have been generated from the information
memorandum that came out right after the reauthorization of the Child Care
Development Block Act and these strategies were identified as kinds of
lowest hanging fruit right the ones that we employ most often, but we want to hear
from you again we want to hear which one of these speak to you and are your
state's using to increase the sigh of quality, so in just a second you're
gonna see your your screen change again and we want to poll you and
have you tell us, please check all that apply.
What are the following strategies that you're using to increase the supply of
your infant toddler quality care in your state? I'm just going to give you a
couple seconds and once again if you don't see the innovative or promising
practice strategy that you're using please do talk about it in a chat with
your peer so we can learn from you, or if you're not sure what your state is
providing feel free to say that too, in the chat box, so thank you.
That's awesome a lot of you are using the Early Head Start Childcare Partnership Model and
very exciting we're getting that preliminary data on efficacy of the
partnerships and collaborations and what those mean for children and families is
very exciting many of you are engaging in the technical assistance and business
practices, awesome building the capacity of those programs to sustain the
business aspect of it, essential. Not seeing, oh thank you Kathy I'm gonna
check the little broadcast results little box on here so you can see that.
Hopefully you can see it now, some of you are using Community Health, some of you
are using financial incentives, but by and large ongoing technical assistance
and support is is a huge practice and an evidence-based one, right. It's helping
our programs improve their quality and sustain and stay in business, right. Thank
you so much for taking some time to to share with us those strategies, we know
that your child care development fund administrators discuss them
in your childcare development plans that are publicly available but
it's always good to kind of see theory to practice there and what's
happening so we appreciate you sharing your responses here and selecting all
that apply. And then please do if you want to talk about something that you're
really excited about that your state is doing please chat it in the chat room
that would be great.You can see your screen changing just a little bit again
and we'll get back to the PowerPoint. In this next slide here you're going to
see about, we know we have strategies right, and then with that we
want a couple of the financing practices with it and so this slide talks about
some of the financing strategies that we can use to really bring those
approaches to life for increasing the supply, and here your your usual you know
lowest hanging fruits here we would be remiss to not mention that 30% that
we want to make sure we allocate and dedicate to the infant/toddler portion
of quality improvement. And then some states are using capital financing
grants and loans we have lots of examples of that and some reports listed
later on this slide subsidy rate setting this is interesting you know for example
Delaware found that it leads to them, it's not practicing now, they did in the
past found that through a cost modeling that it's reimbursement rate for infant
toddler care was actually not sufficient to attract providers and so they made
adjustments accordingly so that they could make sure that that
reimbursement rate matched the true cost of quality so that an infant toddler
care provider could stay in business. We know tax incentives and credits
incentives to convert infant toddler classes
that layering and braiding of funding we've learned a lot about that through
the partnerships grant right. And in Maryland and Minnesota for example have
required or have given points at least at one time
for child and adult care food participation their quality rating and
improvement system so some examples there of how two states have layered
and braided funding that's available for just participating in quality activities,
right. And then this is one of the examples of a strategy to improve the
quality and supply and you can see from Arizona and in Georgia two non Early Head
Start childcare partnership, public-private partnerships examples
here I know we focus a lot on the Early Head Start childcare partnerships and
there's a lot of other partnerships as well that can increase the supply and
quality and you see here Georgia has a "Talk With Me Baby" that's a cross sector
professional development for health nutrition that's advancing the
professional workforce development there and they partner with health and
education higher education and the state so they've engaged all of our partners
in Georgia at that level with this professional development initiative. And
then in Arizona the first things first you can see here that these local
councils are allocated with state dollars to provide this family-friendly
comprehensive collaborative and of early childhood comprehensive systems approach
to development and health for Arizona children so all kinds of
public-private partnerships and these are just two those. There are more listed later on
in the webinar. And then another strategy is the use of hubs and please know that
this is not exhausted by any means, if we listed all the examples we would be
going on for three hours here but you know hubs are a model established
privately or by that government to provide a variety of supports to child
care providers and some hubs are used as a center to associate family
child care centers with and others are a cluster of smaller centers with high
quality center as a hub and they provide a variety of early childhood services
but it's a way to streamline and create efficiencies and economies of scale for
business for child care and here are two examples here, in
Maryland and in Oregon and then a couple more strategies before we then launch
into hearing from Renee on the business aspect let's see we've got one of the
really promising practice that we're getting some emerging data on and a lot
of people are jumping into is the practice of implementing staffed family
childcare networks, and these are more than just kind of associations of family
child care providers and where they network together this is a full-time
with at least one full-time equivalent of a person who is working to support
the quality improving a family child care. We know that families with babies and
toddlers often prefer family child care, right, as a setting for their
early care for their infants, and so here are three examples in three states.
Connecticut has a local example in New Haven of All Our Kin and you can
see they provide a variety of the strategies that improve the quality of
infant toddler care, as well as training and networking and lending libraries and
accreditation support and and all kinds. And then Massachusetts has one that's
specifically dedicated to supporting women in business and so that's kind of
the lens on the Acre Family Child Care mission. And then finally in Virginia
the Infant Toddler Family Day Care is a private nonprofit, and they are licensed
to recruit and screen, list licensed by the Commonwealth recruit and screen
family child care providers and help them with their credentials and also
their ongoing kind of business development supports that they might
need and resource and referral services and connecting those families
with the care. So from the business aspect to supporting and
connecting the families with the care. There are lots of different models of
staff family child care and there's a resource later on in the webinar in the
slides on a technical, a new technical assistance manual that's come out from
the Quality Center and on how to start and implement and evaluate effectively
infant toddler or staff family child care networks. And there's also a cost
estimation model that's this link there and then just a brief on kind of their
research around the staff family childcare network so that is that's a
one of strategies for increasing quality of family child care that's gaining a lot
of a lot of attention lately. So I think we are going to head into
see if Rene is on. Rene are you on? Rene: Yes, I am. Awesome ok just checking to make sure
you're there. The last strategy that were going to talk to before we
transition into Renee is the use of grants and contracts to increase the
supply and there are currently 43 states, 43 of you are using grants and contracts
to enhance the supply. In this strategy is where the subsidy is received through
this grant and contract instead of that traditional voucher following the child
and family so some of you are employing these to
see if it has an impact on the continuity of care, the sustainability of
the provider, and you can see some data here in this slide on that practice
on which states are doing what and of course you know some of this
is happening in the Early Head Start Child Care Partnership world and some of
it's happening outside and there's a fantastic resource embedded in the
PowerPoint later on, on kind of a comprehensive look at how to use grants
and contracts or how to start them up if you want to and the states that are
doing them and how they're using grants and contracts. So be sure to check
that one out later, and I just listed one example here of Vermont, they have 15
parent child centers that they use for grants and contracts. They offer support
with a variety of services not just of which is find helping families child
find home care that find child care. Help families find child care rather, they also
provide home visiting, early intervention, or referral. So this is an example of Vermont
using a state who was already providing a family friendly service to provide as
they're granting contracts hub, if you will, to marry both of those constructs, so.
And at this time I I'm so glad you don't have to hear me talk for a while
because I my new friend, Rene Williams, is going to talk to you. She is the
Chief of Child Care Subsidy at the Maryland, as you can see on the slide, State
Department of Education. And she, we got talking and she has a rich history in
region IV where she started out in Alabama, and has probably re-identified
worked at every end of the spectrum of child care and especially related with
subsidy. And knows our dear friends, Calvin Moore in Alabama and some
other friends we knew, we realized we connected on, but I reached out to
Beverly in region 3 and said I would love for Rene to talk to our
peers about what they're doing and I'm really grateful to Beverly that she
said, "yes that sounds great," and even more grateful to Rene, so Rene I'm gonna
turn it over to you now and I'd love for you to tell us the story about what
you're doing in Maryland to centralize the subsidy system and make the care and
impact on the care for infants and toddlers and the quality in Maryland.
Thank You Rene. Thank you Miss Wilcher on behalf of Miss Beverly Wellons,
region 3 Program Manager; Miss Elizabeth Kelly, Maryland CCDF
Administrator. Thank You ICF for this opportunity to share Maryland's decision
to centralize for highlighting research completed by Dr. Rebecca M on
behalf of MSDE and Child Trends and for exploring how the Child Trends data
connects and impacts three of America's most
precious resources infants, toddlers, and their caregivers.
The hardest slide for me to develop is this slide right here that has an
overview of my work history and influence, each dot on this slide
represents a large part of who I am and what I hope to become. Today is
day 481 in my current position on days when the learning curve appears like
Mount Everest each dot on this page is the concept of hoping and reminder of
what I need to become in order to move forward on team CCDF. Each dot represents
people places and agencies and 22 years of work to support CCDF administration
and regulation and case managers. Dot 604 represents the name given to the CCDF
final rule, and taking the final rule home to read over a weekend my first
response was, "604 pages who writes 604 pages" in reading 604 my life was
profoundly changed because of 604 provided me with the whys behind the law
it connected my dots and enabled me to clearly see faces of infants and
toddlers behind each decision made by CCDF administrators. The dot child trends
connects my entire employment history my initial employer child care resource
center proposed to Alabama Department of Human Resources, let us demonstrate what
happens when childcare subsidy is determined by an agency that only
authorizes child care subsidy and where the agency single focus is early care
and education, as a result of the CCRC pilot a form of centralization called
Child Care Management Agencies was born in Alabama. After supervising a child
care management agency in Alabama for 13 years and managing two child care
subsidy programs in Maryland for four years. I understand firsthand Maryland's
decision to centralize which begins on the next slide. Parents on our subsidy
program work or attend educational training programs in Maryland,
Pennsylvania, the Virginias, Delaware, and Washington DC. The red circles represent
children and working parents that are the hands and soles of industries that
provide food, clothing, safety, comfort to Marylanders, and in some case the world.
They are valuable to society and as their child's first teacher
the red dots number it one through twenty four represent the local
departments of Social Services located in Baltimore City and within the 23
counties that comprise in Maryland. The blue dots represents CCS Central, CCS
Central is a single vendor that contracts with MSDE to complete
statewide provider payment, overpayment calculations, and child care
authorizations. The white star represents the location of MSDE, the CCDF lead for
Maryland, details on the Maryland subsidy program continue on the next slide. The
figurine represents MSDE, Maryland is currently serving over 10,000 children
on the state subsidy program and we have over 4,000 eligible children on our
waitlist. A family size of four submitting an initial application would
be wait-listed with income slightly over $28,000
although Maryland had the third highest state median income in 2016 there is a
high price tag associated with living in Maryland for example, housing in
Montgomery County is comparable to New York City, New York and the average cost
of infants care in the same county it's $1,400 a month so with Maryland subsidy
rates set at the 10th percentile of the market rate survey
access to higher quality child care is often not an option for parents eligible
for child care subsidy. The next slide captures Maryland decision to centralize
the figurine on the left represents MSDE our administrative oversight is limited
based upon case managers being located in 23 counties and in multiple locations
in Baltimore City. Case managers that manage multiple eligibility programs are
employees of Department of Human Services and who have direct supervisory
and administrative leadership that have separate bottom lines, separate mission
statements, separate eligibility focus, and output, and they do not report to
MSDE, the CCDF lead. The figurine on the right represents MSDE having
administrative oversight over one vendor in one location who only authorizes
child care subsidy and it's financially penalized if monthly service level
agreements related to authorization are not met.
Surely, when Maryland made the decision to centralize someone had to ask the
question what is much, what is less problematic to manage 24 or 1, or 1
versus 24 another paramount reason for centralization is on the next slide.
De-linking, Maryland needed to delink meaning two separate childcare subsidy
authorization from all other eligibility programs in order to increase continuity
of care for children. This slide depicts what often happens at the case
management level, the figurine on the left is a case manager who manages four
eligibility programs it's her lucky day because child care subsidy has just been
added to her caseload, although childcare subsidy authorization is 12 months
the case manager decides to align childcare vouchers for six months and
will deal the remaining six months at redetermination, although this is a good
case management strategy it is a strategy that could result in
childcare being ended prematurely. Reauthorization allows CCS alignment
with other redeterminations as long as the authorization is 12
months, or when aligning the clock for CCS authorization is reset fir 12 months.
Another example of delinking is on the next slide. On this slide the parent
failed to comply with TANF requirements, so the case management ends childcare
vouchers until the parent comply. In Maryland case managers often manage
multiple eligibility programs and use child care subsidy vouchers as a carrot
to get parents to comply with other eligibility programs. Maryland's decision
to centralize was based upon the need to totally delink child care subsidy
authorization from all other eligibility programs in order to decrease the
interruption or the delay of childcare authorization. A final example of
delinking is on the next slide, as Maryland continued to look at data
Maryland noticed voucher durations for two weeks, four weeks, or two months often
for the same child as a result the child revolved in and out of child care, in and
out of childcare, delinking child care subsidy eligibility from all other
eligibility programs remains a very hard concept for case managers managing
multiple eligibility programs, as barrelling
continues to look at data our goal to delink childcare subsidy was to protect
and promote the social-emotional development of children. Maryland's path
to centralization is captured on the next slide. In October of 2015 with
continuity of care being a major pillar of reauthorization MSDE modified our
computer system to have a soft default to 12 months on August 31st of 2015
Maryland fully centralized, like renovating a 300 year old house you can
plan, allocate, and a lot of resources, but until you get behind the walls and down
to the foundation you cannot truly predict the cost of the unexpected. On
December the 18th 2015 Maryland had to modify full centralization to the model
that is depicted on the figurine. The challenges with transitioning are on the
next slide. Variation and policy, interpretation and implementation
Maryland has one policy that governs the child care subsidy programs upon full
centralization paraphrasing the lowest commercial with this, I never knew there
were so many different shades of blue, MSDE did not know the extent of the
shades of policy interpretation and implementation until sensation occurred,
culture parents and providers had a hard time accepting of work drop-off
documents volume prior to the transition total calls received by the local
department statewide were less than 6,000 per month. During the initial
months of centralization CCS central received over 40,000 calls
per month, per month. Program priorities, once centralization was announced
child care subsidy authorization was no longer a priority for many case managers
so parents and providers were penalized, computer systems not having system roles
modified or restricted at the point of the transition had a negative
consequence on a transition. Human Service versus automation, we
underestimated the cries from parents not having place to go that was very
familiar to them. Another visual of the transition is on the next slide. Prior to
August 31st, the 24 local departments issued CCS vouchers to TANF and non
TANF clients from all this is 31st through December the 18th CCS central
issue vouchers for the entire state of Maryland the figurine in the blue dress
represents Maryland's current structure as the stars on the figurine
suggest the bronze star goes to the figurine in the pink dress the silver
star goes to the figurine in the blue dress this is a structure that is not
ideal, but Maryland has greater control over two-thirds of the subsidy cases
that are authorized on behalf of MSDE with this configuration and the gold
star goes to the figurine in the green dress,
once centralization has been given an opportunity to grow. Some of the benefits
of centralization are on the next slide.
Faster application processing from all points of documentation received CCS
Central is currently processing applications in seven days or less
policy implementation and interpretation assistance and checks and balances is
always easier with fewer or one entity. Increased benefits to children when
application process sooner vouchers are issued sooner and children access
child care sooner when continuity of care is increased the child reaches the
developmental benefits the challenges with transitioning to centralization are
on the following slide. Please forward the slide. Sorry Rene, thanks This slide
demonstrates work that is completed by, that was completed by CCS Central in the
month of June, July, and August. Data speaks volumes and tells CCDF
administrators whether or not subsidy is being authorized in accordance with CCDF
regulations and the health and welfare of the program that's being
administrated. Having the ability to access and review data is critical
because the case manager is the draw bridge between the intent of
reauthorization and the benefit of reauthorization reaching the child, what
a case manager does or does not do and how they implement policy will determine
if subsidy is authorized in a manner that promotes stability and continuity
of care or impedes positive social-emotional development of children.
Lessons learned are on the final slide.
Know the history of CCS in your state knowing the past will help identify
potential allies and adversaries if your state is planning to make a transition
similar to Maryland. Know the impacts on providers, providers are normally silent
unless their payment is impacted do your best to make sure their payment is not
impacted. No components and barriers to the provision of seamless services the
closest sense the closer centralization looks to the before picture the easier
the transition will be for parents and providers, know everyone will not
cheer your state's decision to centralize, if the slightest change is
felt by most before making a decision as tremendous as the decision to centralize
authorization. Go ahead and buy stock and apron because tomato throwers
will be encountered. The squeaky wheel gets oiled resolve matters when
only a drop of oil is needed know your why when faced with difficulty Maryland's
decisions to centralize was to increase continuity and stability of
care for children by having greater controls at the case management level.
Again case managers are the draw bridge between the intent of reauthorization
and the benefits of reauthorization reaching the child. Maryland's decision to
centralize was to have better controls at the case management level. In
conclusion, I hope Child Trends will be able to expand the research conducted in
Maryland across all states and territories. I truly believe that the
expansion of their research will let us know as CCDF administrators whether or
not the procedures we put in place to increase continuity
here for infants, toddlers, and children are taking hold. Thank You ICF for this
opportunity to present. Thank you Ms. Wilcher. Thank You Rene, that, your story is just
so, I have just such a visual of my head of these babies staying longer and
the their family's arms and then the caregivers arms and I think about the
webinar that I heard you speak on with Child Trends when they were carrying the
data and you had me at continuity of care and I just am really really glad
that you were on today for us. And we we do have one question and you
may not know that the answer to this and that's okay and I encourage others to
you know, Rene got a lot of great questions as she's been doing this
process of implementing this approach, and as she mentioned Child Trends has
been working closely with her to evaluate, which we're going to talk about
in a little bit the the efficacy of this approach, you know, is it making a
difference, but Rene one of the questions that I want to ask you that
Mandy has, and Mandy I'm not sure where you're from but you don't you don't have
to say that but you put it in the chat, when you were delinking with the
eligibility of the other programs what implications of that does that have on
your data sharing that they still have the data to share with you, do you have
data sharing agreements or MOUs, what were the implications on that with
sharing the data across those other other programs, do you know? We
still shared data across other programs and in reference to the delinking and in
reference to the 604 the final rule one of the things that it talks about is
that child care subsidy is delinked from the other programs, so we still work with
all the other eligibility programs but the main point in reference to delinking
is that child care subsidy authorization, the policies, and the procedure
are separate from other regulations. So what was happening in Maryland and what
continues to happen and what we continue to work on is that for example, if a
parent is authorized for child care subsidy that means that they have met
all points of eligibility, at the point of meeting all points of eligibility
that parent is eligible to receive a voucher for 12 months. But if a case
manager is managing a TANF program for example, and the worker stops, the
parent stops participating in TANF what the workers often do is they apply their
TANF rules to childcare subsidy and they end the vouchers, so to answer your
question we have a memorandum of understanding with the Department of
Human Services which allows their workers to authorize vouchers on behalf
of Maryland State Department of Education. We still share data but what
we have to delink is to get the workers to understand that they cannot change
childcare vouchers based on what's happening in the other program. Excellent
I remember you saying, Rene, and it really hit me the realization that the
your work force the professionals had when they realized that they could
not just discontinue you know the services not services, but the voucher
and what a wake-up call that was and that the eligibility you know would
continue on regardless of you know the previous and the process that you went
through of streamlining that and sending that message out and and so that
everyone was on the same page and there was one shade of blue. Rene: Right and so I
just would like to add to that by saying we're still working on that process and
ICF is going to help us to get the message out and as I stated in the
beginning not only was it a wake-up call at the case management level it was a
wake-up call for me as I stated at the beginning of the presentation when I
said and I actually read the 604 and I got to the point in the document where
it talked about how children learn and what impact is made upon them when they
are snatched in and out of childcare and how children learn by being in stable
environment. It made me say wait a minute, all this time I have said I serve
children but in all actuality I don't really know if I look beyond trying to
pass the next audit or trying to make sure we didn't make any mistakes I
didn't understand the full impact of what it was that we were doing so that
604 was a wake-up call for me and yes as Maryland continues to talk to case
managers more yes they are in shock because like for me
their focus for for many years has been on the parent and not the child and I
think that that's just an overview of what the whole reauthorization is all
about it's about making sure that the funds and what we do promote the welfare
of children. Rene that's just so beautifully beautifully stated and in
what are a revelation and I'm sure that you've got about 58 child care
development state administrators kind of shaking their head here with you if we
could see video today. So we've got about five minutes left in in our webinar, I
have also just want everyone to know linked the Child Trends research and
this webinar with you later on but I think that this is a great segue into
the last section of our time together which is just emphasizing that we can
do all of this but unless we kind of take a look at what's working
and what's not working and what we might want to tweak to improve not only
that that are checks and balances but moreover for our families and children
which I really think are is the reauthorization, as well as best practice
right that lightning bolt that you had Rene about learning that we're really
would be remiss. So we talked about all these strategies and Rene highlighted
what she's doing through, what Maryland is doing the centralization to
create that continuity of care and eliminate that bouncing around of
children and families and the deleterious impacts we know that has on
their development to make sure that they're staying with those warm and
nurturing arms longer and in this quality care longer. We want to talk
about how you measure progress so as we're talking about a couple of examples
if you want to chat the chatroom ways that you're in measuring the impact of
your your strategies for supply building please share with us, some of you might
measure the progress by increasing the supply of quality care for infants and
toddlers, Rene and Maryland has data on the continuities care of children and
care so exciting and they're going to continue to have more data as the time
goes on and warrants may be you measure it by more infants and toddlers with
with lower incomes having quality of care, maybe you measure it by the
increase in the competent and qualified workforce right so there's a lot of
different ways to measure and here's one resource a national resource and I just
I love this resource and I know that my team will probably laugh at me because
it's like any strategy that you have if you want to develop, implement, and
evaluate its efficacy this resource right here the Integrated Stage Based
Framework Implementation helps you from beginning to finish plug in any early
childhood effort you have to make sure you've got that continuous quality
improvement process embedded in your implementation so it's linked right here
it's a brief by OPRE and it's a call it a fail-safe way to evaluate any
of your your strategies. And then later on I'm going
to scroll through a couple of these you've got some some other additional
state and national state examples and national resources for supply building.
Here's a state strategy that Michigan used to help families access care, they
did you know, What Can Michigan Do to Help Parents and Children Access Quality
Care they did a study and conducted some shares and recommendations and findings
there. Another state strategy, Nebraska looked how many
what's the our workforce looking like I'm is it competent and for specifically
for infants and toddlers we've got just a ton of these planning and practices to
consider, planning and policies to consider when implementing contracts and
grants, which is another promising practice a clasp has issued this also
another great national resource to help States and guide states in their
implementation of the best practices for building infant and toddler quality
and supply of care. And I'm just going to scroll through a couple of these
there's a lot of other examples of states measuring their progress there's
a report out of New Haven and and we have a resource on the Infant/Toddler
Resource Guide which we can link that that in the chat box on a variety of
other state and territory approaches to improving the quality and supplies of
infant toddler care. So there's one minute left I would be remiss not to
thank all of you for being on today and reminding you that there's a
questionnaire linked in your chat box that allows you to tell us how
about your experience today and what worked well and what you benefited from
and what could have been a little bit different for you to better meet your
needs and in your learning about how to increase the supply of infant toddler
care. And we encourage you to look through the state examples and national
resources found later on this webinar and also just want to bring your
attention to the Child Trends data that's linked from
from Rene's research in Maryland with with checking on how the centralization
was implemented and how well it's working and what's their data on child
and family outcomes from that so thank you so much Rene for being on with us
today and and taking your time to share your story. I also wanna thank Kelley
Perkins and Ronna Schaffer for, my Infant/Toddler Specialist colleagues,
helping me with the technical aspects and I want to thank all of you who are
working so hard to implement the reauthorization and implement these
strategies to to build the quality and supply of infant toddler care and your
in your state and territory. We were glad to have you today and look forward to
seeing on the next hot topics webinar and we wish you all well, goodbye.
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