Implementation Examples
TRANSCRIPT
Robert McLellan
Assistant Director, Washington State Department of Early Learning
So to talk a little bit about what we’re doing in Washington and give you an idea of where we are in the landscape of the key indicators and some of the quality, we moved from purely a paper-based file system 2 years ago to a tablet-based system, which was an important step for us because it allowed us to start to gather data about our licensing activities that otherwise would have taken months, if not years, to dig into the paper files.
We finished updating two of three full sets of rules. Our family child care rules were updated in March of 2012. Our school-age rules were updated in December of 2012, which is a good thing because it’s aligned them to more current research, particularly around Caring for Our Children, and it puts us on track now for having about a year’s worth of data in the family child care rule set. So we’re now moving forward to start to look at the States’ key indicators specific to Washington State’s regulations.
Up to this point in time our system has been heavily reliant on the 13 Indicators of Quality. We’re using a differential monitoring-type approach; we don’t reduce the number of visits that we make, but we do differentiate how we treat each visit.
The difference is fundamentally the difference between about a 13-page checklist and about a 4-page checklist in terms of timeframe for licensing. We have a set of the high-value or high-risk key indicators that we use to move away from an abbreviated or a short checklist to the full checklist, and we look at ratios, supervision, capacity, discipline, and staff qualifications. So, if there’s any noncompliance on a monitoring visit in an abbreviated format, staff then go to a full checklist, look at more detail, and dig in on the compliance with the larger set of regulations.
Karen Beckerman
Strengthening Family Services Director, Kansas Department for Children and Families
In Kansas we wanted to look at how we can best use our licensing process, balance our workload, and increase consistency with the staff, and efficiently use our surveying staff that we have across the State. A new law passed in Kansas, Lexie’s Law that resulted in doing away with our registered or our self-certified providers, and so, they either had to become licensed or [could] no longer provide care. So, in order to take on an additional 2,500 providers with the same number of surveyors, we proceeded to see how we can be more efficient.
In January we kicked off our plans to use a key indicator model; about 2 years ago we automated our inspection tool. So we went from paper files to getting our licensing compliance surveyors on a tablet. Next, we took the data and identified our key indicators, and then we decided what are the rules, how do we apply them, and when do we use the key indicator survey? So, the Kansas Department of Health and Environment looked at what criteria do we need to meet, and they identified a list of about 10 criteria the providers needed to meet in order to be eligible to begin a survey. At least every 3rd year, the State would be doing a full compliance survey when they go out to visit a provider.
There will be the key indicators regulations that they must go through. They have identified high-risk regulations they want to address with all providers, so that will be in that key indicator survey, and then
there’s going to be a selection where the system randomly selects about five regulations that can vary from time to time.
Also, in the policy and procedure manual there’s going to be situations and training for staff on what to do when you see an obvious out-of-compliance regulation and how to address that. So if they are answering the key indicator regulation, and something is out of compliance, that actually will cause our system to pop up maybe additional questions or regulations to check. If there are things that are out of compliance, that it can actually turn into a full survey while they are going through the process.
We hope to be able to provide additional technical assistance with the providers that need that additional time from our surveyors and also the compliance issues that continue to come up that we need to direct our training for both our providers and for our staff.
David Collins
Director, Division of Early Care and Learning, Colorado Department of Human Services
My main message today is that developing the system of indicators has as much to do about the health, safety, and welfare of children as it does about people management. We have a single document that we use to inspect facilities. So, if you’re on an original visit or an annual renewal visit, you will do every item. However, if the facility is on a 2- or 3-year visit code, they’ll just do the items that we call core indicators.
Under Policies and Procedures, we’re really only looking at a handful of all the policies and procedures we require if we’re on an abbreviated visit, using core indicators. So some things are really important to us every time we go out, including having a policy of identifying where children are at all times.
We also have a problem with discipline, so we have them review that. On communication and emergency procedures, we’re really big on the sign-in/sign-out sheet, so we make sure that’s in use every time. That actually is not just for safety of children; it’s so that we can conduct child care subsidy audits in a meaningful way.
Visitor policy is important, and emergency numbers is something we’ll always check for. Our key indicators far exceed probably what Mr. Fiene would look for in key indicators. Over half of the indicators are core indicators, which is probably not a good, efficient model for a licensing inspection.
We’re moving to a digital registry or public information system for professionals so that my staff won’t be looking at paper files anymore once the registry is in place. All things—criminal background checks, transcripts, training hours, hours of experience—will all be in the database. Theoretically, we’ll be able to pull it up before the visit and spend maybe 15 to 20 minutes on it instead of 2 or 3 hours. We’re also moving to a tablet-based system. Right now, we’re still paper based, but we’re modeling and testing a new tablet-based system that will allow us to aggregate data and do this more efficiently.
Adia Brown
Monitoring Lead, Office of Head Start
I’m going to tell you a little bit about the Head Start Monitoring model. We actually monitor 1,600 programs across the Nation.
Our reviews occur every 3 years, as mandated by law. We may send a team out that is as small, depending on the size of the program, as 4 reviewers and as large as 30 reviewers.
We send those folks out for about a week, and they do a comprehensive monitoring protocol. We don’t have a 100% compliance tool. We look at about 130 of those regulations during each monitoring visit.
One of our key regulations is: “Do you have a State license?” So that gives us sort of a baseline to understand whether or not you’re actually meeting the licensing in your State.
We look at child development and education. So, we understand things about teachers and classrooms and whether or not they have good teacher interactions. We do that in two ways: we do it with our monitoring tool; we also do it using the CLASS tool. So that helps us look specifically at teacher interactions, and that provides us with another level of a quality indicator that’s different from performance standards.
Looking at family childhood engagement, which is another sort of philosophy or premise of Head Start, to make sure the family is actually engaged. So, we monitor that to determine whether or not our families are actually getting the best experience, and learning to become self-sufficient, and actually moving out of poverty and Head Start.
We look at fiscal because this is a grant program, and we have to make sure that we understand the fiscal responsibility of the agency, and we have accountability to make sure that they are spending the dollars appropriately. Governance is a huge part of Head Start programs, so we have members of the team that actually look to see whether or not they have a governing body who has oversight of that program. It’s an important indicator for us, because without a strong governing body, we know that Head Start programs don’t typically do as well.
We look at management systems. There are about five key areas of management systems that we look at to ensure that they actually have a system to cover all the areas.
We started off with eight key indicators, and those eight key indicators are sort of a mix of program compliance and program quality; our database is extremely robust. Every indicator that we actually have, we have data points on it.
We also have another system that works in conjunction, in some ways, to monitoring, called Designation Renewal. Another piece of history for Head Start is that all our programs were actually indefinitely funded for a very long time, and they’re in a new system where they get 5-year grants. It’s called Designation Renewal. That has kind of raised the bar for Head Start in a lot of ways because programs are, like, “Huh? I don’t get my grant anymore? I have to actually compete?” And because of that, when we are thinking about Head Start key indicators, we have to make sure that the validity of them actually catches programs that would be out of compliance at a high rate.