The Need for Health and Safety Standards More Now Then Ever

I have written about the child care trilemma in this RIKINotes Blog several times, a term coined by Gwen Morgan many years ago, but it’s relevance is as significant today as it has been since it was originally proposed by Gwen. The trilemma essentially describes how availability, affordability and quality all intersect and as you adjust one how that adjustment influences the other parts of the equation. I have spent the majority of my professional career on the quality side of the equation. Worked on availability and affordability a bit when I was research director for the Office of Children, Youth and Families in attempting to cost out an effective and efficient delivery system of child care services for families in Pennsylvania. But my focus has been on licensing measurement and monitoring systems over a 50 year career which is still continuing today.

As a research psychologist and a developmental regulatory scientist, I was interested in how licensing and in particular how health and safety standards had an impact on children while attending child care. This interest was ignited because of a long term professional affiliation and collaboration with a pediatrician who also had a keen interest in child care health and safety, Dr Susan Aronson. Sue and I started work together back in 1975 when she and I designed and implemented the Child Development Program Evaluation System for the Commonwealth of Pennsylvania. This system influenced our careers tremendously as both Sue and I became advocates for national health and safety standards. Sue focused on the standards while I focused on the program monitoring systems.

In the late 1980’s into the early 1990’s, the first edition of Caring for Our Children (CFOC) was developed and published. Sue played a very significant leadership role in getting CFOC to fruition. Since that time CFOC has gone through 3 editions (now in its fourth edition) and has been a main research resource for state licensing administrators as they revise and promulgate their own child care rules more locally. It also morphed into a series of publications that helped to streamline and focus its standards based upon risk assessment (Stepping Stones to Caring for Our Children) and another document based upon predictable key indicator risk assessment (Caring for Our Children Basics). All these documents played key roles in helping to move the needle forward towards voluntary national health and safety standards, especially with publication of Caring for Our Children Basics which was encouraged to be used across all early care and education programs by the federal Administration for Children and Families.

Unfortunately, the COVID pandemic has thrown this delicate balancing of the trilemma equation out of balance. The gains made have been lost and there is the definite possibility of things getting worse as American Rescue funding for child care will be terminated as of September 30th of this year. The focus will be on availability followed by affordability and with quality in a distant third place. So the trilemma equation will be severely out of balance. The concern is that there will be a continuing eroding of the health and safety standards that are part of the quality dimension in the trilemma equation. It started during the COVID pandemic as states focused on trying to keep facilities open and operating. Since 2020, there appears to be a continuing concern by child care advocates that this trend of relaxing health and safety standards will continue so not to impede new child care facilities from opening and to keep existing child care facilities from closing. The ultimate result will be that the gatekeeper function of licensing will be reduced if this trend continues and our nation’s children will be put at increased risk of morbidity and mortality.