7.1 Quality Activities Needs Assessment

7.1.1 Needs assessment process and findings a. Describe the Lead Agency needs assessment process for expending CCDF funds on activities to improve the quality of child care, including the frequency of assessment, how a diverse range of parents and providers were consulted, and how their views are incorporated: An analysis of supply and demand was conducted during federal fiscal year 2020 through the Preschool Development Grant Birth-5 year olds in the comprehensive needs assessment analysis posted at https://www.earlychildhoodhawaii.com/resources. This analysis referenced Hawaii early learning needs assessment, DeBaryshe, B.D., Bird, O., Stern, I., & Zysman, D. (2017). Honolulu: University of Hawaii Center on the Family. Department of Human Services (DHS) collaborates with the Executive Office on Early Learning (EOEL) to determine the methodology and scope of any subsequent assessments. In addition, the University of Hawaii Center on the Family conducts assessments on a reoccurring basis to refine data from published reports. DHS is collaborating with EOEL around State's 2022 PDG B-5 Renewal Grant to conduct an update Needs Assessment on the needs of the early childhood system post-pandemic with an intentional focus on the needs of the infant and toddler care system. b. Describe the findings of the assessment, including any findings related to needs of different populations and types of providers, and if any overarching goals for quality improvement were identified: Hawaii’s 2020 statewide early childhood system needs assessment was carried out by the Inner City Fund (ICF) project team in the Fall of 2019 with support of Hawaii based consulting partner Summer Helms assisted by Elizabeth Brey, PhD, on behalf of the Department of Human Services and the Executive Office on Early Learning. The report reviewed major findings from the previous needs assessment and did a risk and reach analysis. The report recommends: 1. Increase the capacity of childcare and preschool programs targeting infant and toddler seats and child care in gap regional areas. A. Coordinate for greater efficiencies and funding streams for distribution of programs. Increase and diversify funding streams including state, county, and business support. B. Update the Department of Human Services tuition subsidy rates and develop other solutions to help providers remain in business. 2. Decrease out-of-pocket costs, especially for low- and moderate-income families, while protecting freedom of choice in selecting care. A. Increase the pool of funds for tuition subsidies and reduce co-payments so that recipients spend no more than 7% of family income on childcare. B. Ensure that subsidies reflect the differential cost of infant-toddler care. 3. Support high quality early childhood experiences throughout the community. A. Explore options for quality metrics and a continuous quality improvement system. B. Assist and provide incentives for providers to become accredited. C. Provide outreach and support to informal family, friend, and neighbor care providers. D. Educate families on how to identify high quality childcare and early learning options. 4. Make strategic investments in a skilled and stable early childhood workforce. A. Develop strategies to strengthen career pathways. B. Ensure that professional development offerings are tailored to the unique needs of each sector and Increase access to evidence-based practices such as ongoing coaching. The Department of Human Services has developed the following goals for quality improvement that align with the report’s recommendations: Goal 1: Promoting access to quality and accredited child care for low-income families receiving the CCDF subsidies. Hawaii’s 2020 needs assessment found families choosing legally exempt care rather than licensed care. Families reported limited slots are available in licensed and registered child care settings, the cost of regulated child care, or where the opening was available were reasons for choosing legally exempt care. In adjusting the child care payment rates and reducing family co-payments for accredited and licensed child care providers, the Department of Human Services may be able to identify trends as to whether families would shift to utilizing accredited licensed and registered child care homes and facilities when their out-of-pocket cost for such care is lowered. The Department of Human Services analyzes the utilization trends annually to monitor whether or not families shift to accessing accredited licensed and registered child care homes and facilities when their out-of-pocket cost for such care is lowered. The Department of Human Services will continue to evaluate the feasibility of implementing technical assistance services to increase the number of child care facilities that complete the accreditation process for both National Association for the Education for Young Children (NAEYC) or the National Early Childhood Program Accreditation (NECPA). The Department of Human Services facilitated and supported two (2) child care homes to complete National Association for Family Child Care (NAFCC) accreditation. The Department also facilitated and supported two (2) child care homes in completing the renewal of their NAFCC accreditation. The pilot project going into their 5th year looked at strategies to provide opportunities to registered family child care homes on the Neighbor Islands as well. The Department raised the child care payment rates for group care and NAEYC and NECPA accredited centers. The Department of Human Services also established higher payment rates for family child care homes that are accredited by NAFCC when the Department adopts administrative rules to fully implement the remaining requirements for the Child Care and Development Block Grant. The Department of Human Services also established decreased family co-payments for all families receiving child care subsidies and waives a portion of the family’s co-payment when at least one (1) subsidy child between the ages of birth to kindergarten entry is attending a licensed group care facility or early childhood nationally accredited facility. The increased child care payment rates and future decreased family co-payments will allow Hawaii’s working families who are struggling to make ends meet have the opportunity to afford quality child care and promote continuity and stability of care and increase school readiness for Hawaii’s most vulnerable children. 1. The Department of Human Services provides technical assistance services to increase the number of child care that complete the accreditation process for NAFCC and continue to explore the feasibility of support centers pursue and obtain NAEYC or NECPA accreditation; 2. The Department of Human Services provides a higher child care subsidy amount to families due to increased payment rates and lowered family co-payments; 3. Number of child care referral services provided by child care resource and referral agency; 4. Number of unduplicated persons receiving child care referral services provided by child care resource and referral agency; 5. Number of unduplicated persons finding child care as a result of child referral services provided by child care resource and referral agency; and 6. Number of referrals to other types of resources or services needed provided by child care resource and referral agency. Goal 2: Ensuring the health, safety, and welfare of children in licensed and registered child care homes and facilities and in legally exempt, non-relative care for children. Hawaii obtained statutory authority to subject legally exempt child care providers caring for children whose families are receiving child care subsidies to health and safety standards. For federal fiscal year 2020, Hawaii’s children were cared for by 428 legally exempt, non-relative child care providers, the majority of which are home-based providers. Hawaii is an outlier for the proportion of children receiving care by a relative in their home (Administration for Children and Families, Office of Child Care, CCDF Data table 6, Fiscal Year 2009-2019). Implementing health and safety monitoring inspections of such legally exempt, non- relative child care providers presents a significant change for child care licensing staff by nearly doubling the number of child care providers that licensing staff need to cover, in addition to completing the additional background check requirements. Monitoring of legally exempt, non-relative child care providers requires additional training and support for the licensing staff as they transition into the legally exempt sector. The Department will continue to assess the workload and caseload ratio for licensing staff after implementation of the monitoring requirements for legally exempt child care providers caring for children whose families are receiving CCDF subsidies. The Department of Human Services priority is to ensure the health, safety, and well-being of children in care with licensed, registered, and legally exempt providers through on-going monitoring inspections, completion of background checks, and supporting providers in meeting the minimum standards for health and safety for legally exempt providers caring for children whose families are receiving CCDF subsidies as well as for licensed and registered child care providers. 1. Number of licensed and registered child care homes and facilities were provided training services; 2. Number of legally exempt providers caring for children whose families receive CCDF subsidies received health and safety training guidebooks; 3. Number of licensed and registered child care homes and facilities received health and safety training guidebooks; 4. Number of children served by the licensed and registered child care homes and facilities receiving training services; 5. Number of subsidy children served by the legally exempt provider caring for children whose families receive CCDF subsidies; 6. Number of licensed and registered child care homes and facilities receiving health consultation services; 7. Number of licensed and registered child care homes and facilities receiving menu reviews; 8. Number of licensed child care facilities inspected annually; 9. Number of legally exempt providers caring for children whose families receive CCDF subsidies inspected annually; and 10. Number of background checks completed annually. Goal 3: Improving the quality of child care, wherever children are, by providing resources and supports for licensed and registered child care providers and for legally exempt providers caring for children whose families are receiving CCDF subsidies. The Department is interested in continuing to support child care providers in improving the quality of care provided to children and offers a variety of services for Hawaii’s child care providers, including licensed, registered, and legally exempt caring for CCDF subsidy children. The Hawaii Department of Human Services continues to review existing services being provided as well as considering additional services and needs that may be needed. 1. Number of registered family child care providers and child care staff that receive scholarship funds from the Department; 2. Number of registered family child care providers and child care staff that receive a post-secondary degree or Child Development Associate through the scholarship funds from the Department; 3. Number of legally exempt child care providers caring for children whose families are receiving subsidies that are visited and meet minimum health and safety requirements; and 4. Number of children whose families are receiving CCDF subsidies who attend an accredited child care facility or home. Existing contracted services provided by the Department of Human Services are: 1. Services to provide training and scholarship services to promote on-going professional development opportunities to support quality child care settings to interested persons, including parents and caregivers. The trainings include information about research and best practices in child development. The contractor and the Department of Human Services are exploring ways to make community-based child care training more accessible to all child care providers statewide. Hawaii is made up of six (6) primary islands, and there are local community needs and transportation issues. On-line training has been a great help to those providers who reside in areas that are not easily accessible or who lack adequate transportation. Scholarships are provided for post-secondary education coursework to individuals working in the child care sector or not yet entered and pursuing their post-secondary degrees in Early Childhood Education to promote qualified staff and retention of staff through a career pathway. 2. Services to provide infant and toddler training that meets the requirements of initial 30 hours and an additional 15 hours of training in infant and toddler development needed within two (2) years for staff employed at licensed infant and toddler centers. The goals of this service is to increase the availability of infant and toddler care settings by increasing the pool of qualified infant and toddler center staff who are appropriately trained to care for infants and toddlers and increase the quality of care in early childhood settings by providing training which increases the knowledge and expertise of caregivers who work with infants and toddlers. 3. Health consultation services, which trains community-based medical professionals so that they can be health consultants for licensed child care facilities and provides trainings throughout the year to licensed and registered child care providers about current issues or new research-based practices affecting the child care sector, such as emergency preparedness, resiliency, toxic stress, and infectious diseases. As part of the child care licensing or registration application process, the licensing workers provide to applicants a resource listing of available community programs including the health consultation program and community public health offices. 4. Nutrition training and menu review program, which provides community-based nutrition training for licensed and registered child care homes and facilities as well as menu review services for child care programs that are not participating in the Child and Adult Care Food Program (CACFP). As part of the child care licensing or registration application process, the licensing workers provide to applicants a resource listing of available community programs including the nutrition training and menu review program. 5. The Department of Human Services contracts for services to provide educational outreach services, technical assistance, and resources to promote quality of care for subsidy families utilizing legally exempt friend, family, and neighbor (FFN) care and their child care providers as well as registered family child care providers. The contractor sends monthly informational packets to home-based child care providers and subsidy families. The packets provide information about latest research based best practices in child development and care. The contractor also provides home learning activity ideas and reflection surveys that can be returned to the contractor. The provider or family will receive a children book to keep, for each completed and returned reflection survey. The monthly newsletters are posted on the contractor’s website. In addition, the contractor has developed the initial health and safety training guidebook that is being used for all licensed and registered child care homes and facilities, as well as to legally exempt providers caring for children whose families receive CCDF subsidies. The guidebook was also translated in 11 additional languages besides English. The 11 translated languages are Chinese, Chuukese, Hawaiian, Ilocano, Japanese, Korean, Marshallese, Samoan, Spanish, Tagalog, and Vietnamese. The contractor is currently operating a small pilot project to provide facilitation and support for registered Family Child Care (FCC) providers to complete the NAFCC accreditation. The pilot project provides technical assistance, educational outreach services, and resources with the aim of increasing their expectations and efforts to provide quality care that fosters children’s early learning, school-readiness, and healthy development. The NAFCC Accreditation Facilitation Project supports FCC providers in achieving higher quality by offering monthly training sessions, home visits, observations, and one-to-one coaching sessions as they move towards becoming accredited. The project continues to look for ways to expand to provide support to family child care homes on the Neighbor Islands. 6. The Department of Human Services contracts for the Child Care Provider Registry services which has standardized the review and evaluation of qualifications for education and experience for staff at licensed infant and toddler centers, group child care centers, and group child care homes. Additional services that may be considered by the Department: mental health consultation and technical assistance support services to promote children’s social-emotional health; an infant-toddler specialist network to support providers caring for infants and toddlers; piloting home-visitation service model to exempt home-based providers who are friend, family, or neighbor and care for children whose families receive child care subsidy payments from the Department of Human Services; a professional development entity to provide a comprehensive cross-sector calendar of available professional development opportunities throughout the state that can be accessed by the child care workforce; development of a quality assurance process for reviewing community-based early childhood/child care training and trainers to support the child care workforce in its work with children; technical assistance and support services for providers seeking or maintaining national accreditation through NAEYC, NECPA, and NAFCC to promote families’ access to high quality care; considerations for partnering with the Department of Education on the development of professional development opportunities to meet the on-going training requirements for school-age specific providers (home-based and center-based); and other quality improvement opportunities that may arise.