NCCIC A service of the Child Care Bureau Exploring the Complexities of Tiered Quality Strategies Judy Collins National Child Care Information Center (NCCIC) BUILD Conference Call August 19, 2004 Developed by Judy Collins and Tracy Dry, NCCIC 1 Tiered Quality Strategies Enhancing Quality through Systemic Improvements Four Approaches:
Tiered Reimbursement Rated Licensing Quality Rating Combination of Strategies Overview of Tiered Strategies: Quality Rating, Reimbursement, Licensing (November 2002), by Judy Collins and Tracy Dry, National Child Care Information Center, http://nccic.org/faqs/tieredstrategies.html 2 Tiered Quality Strategies Tiered Reimbursement State provides higher rates for child care programs that achieve one of more levels of quality beyond basic licensing New Mexico- AIM HIGH http://www.newmexicokids.org/Resource/Library
3 Tiered Quality Strategies Rated License Quality criteria for each particular level are embedded in the States requirements for obtaining a child care license. North Carolina: Five-Star Rated License http://ncchildcare.dhhs.state.nc.us/parents/pr_sn2_ov_sr.asp 4 Tiered Quality Strategies Quality Rating State develops and markets a quality
rating indicator for use as a child care consumer guide. Educare Colorado http://www.educarecolorado.org 5 Tiered Quality Strategies Combinations of Strategies Combining goals and characteristics of tiered reimbursement, rated licensing, and/or quality rating systems Oklahoma: Reaching for the Stars http://okdhs.org/childcare/ProviderInfo/provinfo_stars.htm 6
Tiered Quality Strategies 36 States* Have Implemented a Tiered Strategy * Not all of these systems have been implemented Statewide. 7 Tiered Quality Strategies 8 States currently operate a pilot and/or municipality/county option * * *
*Pilot Municipality/County Option 8 Tiered Quality Strategies Type of TQS Tiered Reimbursement is the predominant TQS Type of TQS N=41 TQS in 36 States Number of TQS 9
Tiered Quality Strategies TQS Implementation Dates TQS began in the first State in 1989 as TR In Tiered Reimbursement Rates and Rated Licenses (updated May 1999), Gwen Morgan reported 16 States paid more for higher-quality care States are continuing to develop new systems and expand and refine their current TQS Year 1989 1992 1993 1994 19961997 1998 1999 2000 2001 20022003 2004 No. New 1 1 1 1 1 3 5
8 6 4 7 1 1 TQS Number of new TQS Implemented Each Year 1 0 Tiered Quality Strategies Number of Quality Levels Eighteen TQS have three or more quality levels Number of
TQS N=41 TQS in 36 States NR=No response Number of Quality Levels 1 1 Tiered Quality Strategies Categories of Quality Criteria in Multi-level TQS Categories of Criteria Professional Development / Qualifications / Training Learning Environment/Curriculum Licensing Status / Compliance
Parent / Family Involvement Accreditation Administrative Policies & Procedures Program Evaluation Ratios / Group Size Program Quality Health / Safety / Nutrition Personnel / Staffing Staff Compensation Staff-Child Interaction Child Development Number of Programs 17 10 10 10
9 6 6 6 5 4 4 4 4 2 N=18 Multi-level TQS in 20 States States were asked to verify the categories of criteria used to assign quality strategies with more than two levels. These categories of criteria did not include the requirements within the components of quality levels. For the purposes of this analysis, the list of 41 categories sent to States for verification were sorted by topic and compiled into the 14 categories listed above. 1
2 Tiered Quality Strategies 21 States* have implemented a system with more than two levels * Not all of these systems have been implemented Statewide . 1 3 Tiered Quality Strategies Categories of Quality Criteria: Learning Environments Weekly lesson plans that are developmentally appropriate Space arranged in interest areas Children read to 15 minutes a day
Oklahoma, Reaching for the Stars http://okdhs.org/childcare/ProviderInfo/StarsProgram/StarCriteria.htm 1 4 Tiered Quality Strategies Categories of Quality Criteria: Staff Compensation Salary Scale - Level of education, training, experience Benefit Options - Paid sick leave, annual increments, paid vacation, medical insurance, child care benefit, tuition reimbursement, paid family leave, retirement
Pennsylvania, Keystone Stars http://www.dpw.state.pa.us/ocyf/childcarewks/ccwKeyStars.asp 1 5 Tiered Quality Strategies Categories of Criteria: Accreditation Accreditation by a national organization is a common feature of tiered reimbursement systems. 35 States have linked differential reimbursement rates to accreditation. 4 Statewide tiered strategy systems do not include accreditation: North Carolina and Tennessee, MA, CO 1
6 Tiered Quality Strategies Accreditation Issues All systems are not created equal. - What accreditation systems will be recognized in the tiered strategy system? - How will the accreditation systems that apply for recognition in the system be evaluated? Overloaded systems 1 7 Tiered Quality Strategies Issues: Infrastructure What supports are available for
programs to be successful? What is necessary to administer a tiered strategy system? 1 8 T.E.A.C.H. Early Childhood Oklahoma Scholars Program Accreditation Support Stars
Outreach Specialists Training Vouchers Quality Improvement Grants Directors Training The Support Systems ERS in Oklahoma Evaluations R.E.W.A.R.D. Salary Supplement
On-Site Technical Assistance Model Observation Sites Support system information: Center for Early Childhood Professional Development, http://www.cecpd.org 1 9 Tiered Quality Strategies Issues: Expectations Are the steps (or tiers) between the
quality levels too big? Are the expectations for participation realistic? 2 0 Tiered Quality Strategies Why middle levels? Too big of a step to accreditation - Few programs accredited Specific for States needs Trial grounds for want to be standards Enhance licensing requirements 2
1 Tiered Quality Strategies Key Questions Are the goals for implementing the system clearly identified? Are various stakeholders involved for maximum buy-in? Are the demographics of your early care and education profession known? Is there an infrastructure and inter-structure in place to facilitate and support the system? How will the system be evaluated? Source: Adapted from Tiered Reimbursement/Quality Rating Systems Questions to Ask, by Judy Collins, National Child Care Information Center. 2 2
Tiered Quality Strategies Significant Differences Is the system initiated via legislation or administrative policy? Is the system voluntary or mandatory? Is licensing the first level? How many areas of quality criteria will be identified? What quality criteria will be used? Is the quality criteria monitored? 2 3 Tiered Quality Strategies
More Differences Will the program be piloted? Who is the implementing and administering agency? Which agency monitors the child care facility for compliance with the quality criteria? Is there an identified level of substantial compliance? Is a particular score on the Environmental Rating Scale (ERS) required to move to the next level? Does money follow the child or the program? 2 4 Tiered Strategy Systems Unanticipated Issues: Lessons Learned from Oklahoma Workforce
Demographic information of the workforce was not good enough. Staff/directors took time to take advantage of educational supports. More formal education supports were needed. 2 5 Tiered Strategy Systems Unanticipated Issues: Lessons Learned from Oklahoma Compliance Criteria How compliant with licensing standards? - Numerous - Repeated - Serious
Consistently contested 2 6 Tiered Strategy Systems Unanticipated Issues: Lessons Learned from Oklahoma Loss of Higher Rating Property right/license versus privilege/contract - Hearing versus administrative review - Liberty plus; involves reputation and has economic impact Politically as difficult as property right Policy changes so the level reduction will not have the effect of a death sentence 2 7
Tiered Strategy Systems Unanticipated Issues: Lessons Learned from Oklahoma Number of Changes Clarification Correct mistakes Facilitate facility progress Added another level (One Star Plus) Comply with statute change 2 8 Tiered Strategy Systems Unanticipated Issues: Lessons Learned from Oklahoma Attitude of Implementing Staff
Numerous policy changes Complexity Allowing facilities to keep enhancement rate for 4 months Two star facilities that do not look great - Even though better than they were One star facilities that do look great 2 9 Tiered Strategy Systems Lessons Learned from the States Environmental Rating Scales (ERS) Cost Frequency Attitudes of providers
Technical assistance follow-up What does the ERS tell us? 3 0 Tiered Quality Strategies Future Directions: What do we know and what do we not know? Existing systems are growing, both in the number and complexity of levels. What are the costs of the systems? What are the barriers? How do you sell it in times of budget crises? What is the impact of changes in accrediting systems? 3
1 Tiered Quality Strategies Impact on the Quality of Child Care: North Carolina Assessment scores provide valuable insight into the areas of achievement and those areas in need of resources and continuing improvement in child care centers across the state. The findings also provide compelling evidence of an increase in rating scale scores in child care centers* with increasing levels of teacher education. *Ratings are discussed for preschool classrooms, infant classrooms, school-age classrooms, and family child care homes. Source: The North Carolina Rated License: A Three-Year Summary of Assessed Facilities: Executive Summary (May 2003), written by Deborah Cassidy, Linda Hestenes, Sharon Mims, and
StephenHestenes North Carolina Rated License Assessment Project, pages 5 and 9. http://web.uncg.edu/ncrlap/pdf/ExecutiveSummary_Final_5_15_03.pdf. 3 2 Tiered Quality Strategies Impact on the Quality of Child Care: Oklahoma The intent of the Reaching for the Stars program is to improve the quality of individual centers as well as the overall quality of child care in Oklahoma. The findings show that this goal is being achieved. More high quality programs are enrolling children subsidized by DHS, global quality ratings have risen, and teacher-child interactions are generally positive.
Source: Reaching for the Stars Center Validation Study Final Report, (November 2003), by Deborah J. Norris, Loraine Dunn, and Lisa Eckert,prepared for Oklahoma Department of Human Services, Division of Child Care by Early Childhood Collaborative of Oklahoma (ECCO), an Oklahoma University/Oklahoma State University Partnership, page 45. http://okdhs.org/childcare. 3 3 Tiered Quality Strategies ECERS Scores Impact in Oklahoma Figure 9. ECERS-R of 5 or Higher in 1999 & 2002 ECERS-R 5 or Higher 100% 80%
60% 1999 40% 2002 20% 0% One-Star Two-Star Three-Star Star Status Source: Reaching for the Stars Center Validation Study Final Report,
(November 2003), page 20. http://okdhs.org/childcare. 3 4 Tiered Quality Strategies Wage Impact in Oklahoma Figure 12. Average Salary By Auspice & Star Status $10 Salary $8 Nonprofit $6
Profit $4 $2 $0 One-Star One-Star Plus Two-Star Three-Star S tar S tatus
Source: Reaching for the Stars Center Validation Study Final Report, (November 2003), page 26. http://okdhs.org/childcare. 3 5 Tiered Quality Strategies Impact on Subsidized Enrollment Figure 5. Subsidized Enrollment 70% 60% Subsidized 50% 40%
Not Subsidized 30% 20% 10% 0% One-Star One-P lus Star Two-Star Three-Star Star Status Source: Reaching for the Stars Center Validation Study Final
Report, (November 2003), page 9. http://okdhs.org/childcare. 3 6 NCCIC Online Library 3 7 NCCIC A service of the Child Care Bureau Phone: 800-616-2242 Fax: 800-716-2242
TTY: 800-516-2242 E-mail: [email protected] Web site: http://nccic.org Mail: 243 Church Street NW 2nd Floor Vienna, VA 22180 3 8 3 9
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