Putting More Care In Day Care

Beyond the barbed-wire fence, dumpster, and asphalt lot, a sign painted on the wall of a Washington day-care center reads "Love and Care for our Children." Other signs promise a "safe environment" for infants as young as six weeks old.

Yet the center was recently fined for leaving chemicals within children's reach, and roomfuls of babies and toddlers still play behind reinforced metal doors for lack of a playground.

The government-certified center in Washington's Shaw neighborhood is only one indication of a quiet crisis in day care nationwide, as too much demand for too few slots leaves thousands at risk of substandard care, experts say.

The influx of children is fueled by mothers coming off welfare, as well as the growth of two-earner families. States are boosting efforts to safeguard the quality of care but are often hampered by shortfalls in staff. A White House conference on the topic is scheduled for Oct. 23.

Already, between 12 and 20 percent of children in US day-care centers and homes are in unsafe environments that jeopardize their development, studies show. Still, Americans today depend on child care more than ever. Three out of 5 women with children younger than 6 are now in the labor force, triple the rate in 1965. An estimated 10 million to 13 million children are served by child-care centers and homes.

And demand is growing, especially as welfare reform pushes more parents into jobs. For example, in the Chicago area officials are predicting a "massive need" for new centers that can supply a minimum of 12,500 new child-care slots each year. In Washington, 4,000 low-income children are expected to be channeled into the city's overburdened day-care system in coming months. And at least 100,000 children in 38 states are on waiting lists for subsidized child care.

Policing day-care centers

The rush may imperil quality, experts say, as state regulators, hard-pressed by funding cut-backs, fail to keep up with licensing and inspections. "It's a growing concern of almost all the states that they just don't have enough staff to enforce the regulations," says Karen Kroh, president of the National Association for Regulatory Administration (NARA) in St. Paul, Minn.

Some critics say quality is suffering because many for-profit centers pay lower wages and have higher turnover. Some 40 percent of day-care providers are now for-profit, compared with a third a decade ago, says William Gormley, a child-care expert at Georgetown University here.

Another measure of the quality-of-care crisis is that many states are suspending and revoking licenses more often, with some reporting dramatic increases since 1990, according to an April survey by NARA. "We are seeing a lot more criminal background problems and child-abuse history," says Pauline Koch, who oversees child-care licensing for Delaware, where enforcement actions have shot up 45 percent since 1995.

The defects in day care may have major implications not only for parents, but also for US social policy. Welfare reform could falter if child care prevents parents from holding down jobs. Furthermore, recent studies link the mental development of children to the quality of care they get. Such findings are rekindling the debate over whether parents should attempt to take more of their children's care into their own hands.

Children's advocates hope next week's White House conference will cast a spotlight on the shortage of high-quality, affordable care.

Some advocates say parents need to demand good care - and that government should set better standards and monitor providers more closely. "It's a basic consumer protection," says Gina Adams, who monitors child care for the Washington-based Children's Defense Fund.

Yet so far, most Americans have not rallied to the cause. Federal funding for child care, which was increased under the 1996 welfare act, will nevertheless fall $1.4 billion short over six years of providing what is needed for parents who work, according to the Congressional Budget Office.

A proposed national registry for child-care employees has drawn criticism from union officials, who argue government should pay to train, not track, workers.

Innovative ideas

Much of the work in improving day care falls to the states. Several innovations are helping states stretch limited funds to boost quality:

* Improving the efficiency of monitoring by targeting troubled providers. Eleven states are fine-tuning their monitoring so centers that comply with rules can be screened more quickly and less frequently, according to a recent survey by Wheelock College in Boston.

* Monetary incentives for better care in government-subsidized centers. In New Mexico a new program uses the slogan "Go for the Gold." It offers providers Olympic-style ratings and up to $3 more per day per child for boosting staff credentials and lowering child-adult ratios. Oklahoma has a similar program.

* Helping parents make better choices. Colorado has taken the lead by offering parents computerized data from licensing reports via child-care referral agencies. Parents get information on centers that have received substantiated complaints or have violated regulations. "Once the word is out that parents have been empowered, the centers will have much stronger incentives to improve," says Dr. Gormley.