Iowa's child care quality rating system struggles with low participation rates
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Between running for the state legislature, managing a registered in-home day care and holding state-certified child care provider trainings, Cedar Rapids resident Tracy Ehlert stays busy.
But Ehlert, a registered child care provider since 2008, makes time for the state’s child care Quality Rating System (QRS) application each year. Her day care is one of two in Linn County with the system’s highest possible score (five).
Iowa child care providers who go above and beyond the state’s basic requirements in categories like health and professional development can choose to apply for the certification. The score is meant to “show parents ... they are committed to providing quality child care,” according to the Iowa Department of Human Services.
In Iowa, about 30 percent of all state-licensed child care centers and in-home providers participate in this system, according to Iowa DHS records. Forty-one percent of registered child care centers and 19 percent of in-home day cares opt in.
“(Steps like) having a professional development plan are kind of what sets you apart from just being a baby sitter,” Ehlert said. “QRS really shows parents ... what they should be looking for (in a provider).”
Some experts say a lack of awareness and an insufficient supply of child care may contribute to the system’s relatively low participation rates, while some providers blame a cumbersome application.
State officials hope a new and improved certification system, years in the making, will ease application stress and boost child care quality statewide.
Raising the quality of care
Iowa’s voluntary Quality Rating System, created by the Legislature in 2005 and run by Iowa DHS since 2006, aims to “raise the quality of child care ... increase the number of children in high-quality child care settings ... (and) educate parents about quality in child care,” according to Iowa DHS.
The system assigns providers a score between zero — ineligible or choosing not to participate — and five. Requirements differ for child care centers and child development homes, but levels one and two indicate a provider has met licensing standards and has done additional training.
Levels three through five are point-based. In-home providers earn points across four categories: professional development, health and safety, environment and family and community partnerships. Day care centers also can earn points in leadership and administration.
These categories require extra training for directors and staff, among other facility and care improvement measures. A provider’s rating is determined by its point total.
Child care quality and accessibility
Nationwide, most states’ quality rating systems are optional, and participation varies widely, said Simon Workman, associate director of early childhood policy at the Center for American Progress, a non-partisan, left-leaning think tank that has conducted multiple studies related to child care accessibility and quality.
Iowa’s participation rate is relatively low in a national context, Workman said.
In a fall 2016 analysis of rating system participation rates among child care centers nationwide, Iowa ranked 30th out of 39 programs surveyed, according to the Center for American Progress.
However, the proportion of participants who reach high levels of quality is a better way to compare participation, Workman said. Nearly 45 percent of Iowa’s Quality Rating System child care providers have either a four or five out of a five-point rating system.
“That’s pretty good, if nearly half of them are at a four or a five,” he said.
But that doesn’t mean all families have access to these high-quality day cares, said Rasheed Malik, an early childhood policy analyst at the Center for American Progress.
“Rural communities of Iowa, I think, are much more likely to be child care deserts,” he said. “I would suspect that you might have fewer quality rating system participants out in rural areas.”
About 25 percent of Iowa’s ZIP codes are child care deserts, based on analysis by The Gazette and a standard developed by the Center for American Progress.
A ZIP code qualifies as a child care desert under this standard if there are at least 30 children under 5 and the ratio of children to spots in registered child care facilities is no greater than 3-to-1.
Even in some areas with high densities of day cares, like Cedar Rapids, Des Moines and Iowa City, there aren’t many QRS participants for parents to choose from.
In Linn County, there are 248 registered or licensed child care providers. Fifty-six of them participate in the rating system, according to Iowa DHS records.
This means in many urban areas, there still are far more children than there are spots in QRS-rated facilities. For example, in ZIP code 52403, which covers southeast Cedar Rapids, there are 17 kids for every spot in a QRS-rated day care, according to Iowa DHS.
In line with national patterns, Iowa providers may choose not to participate in the rating system because there will always be demand from parents, Workman said.
“Providers say, ‘Well, I already have a waiting list. Why do I need to do these initiatives if ... I’m always going to be full?’” Ehlert said. “But Iowa doesn’t have enough child care slots for all the children that need care in the state, so most of us, whether we’re high quality or not, are going to stay full.”
Additionally, many parents — and some providers — don’t know the system exists, Ehlert said.
Since the Iowa Department of Health doesn’t have a marketing budget, officials rely on word-of-mouth and Iowa Child Care Resource & Referral, an organization dedicated to helping parents find quality care, to inform people about the Iowa Quality Rating System, said Mykala Robinson, head of the QRS oversight committee.
Parents can find out more about the program and providers on the list by visiting http://dhs.iowa.gov/iqrs and http://dhs.iowa.gov/iqrs/providers.
Increasing awareness of the program has been one of the department’s biggest successes since the rating system launched, but it’s still a challenge, she said.
“(Parents) don’t know. That’s the big barrier,” Ehlert said. “If more parents knew and asked, then more providers would be looking to be on it.”
Tiffin resident Rebecca Ausman runs an in-home day care rated a four on the rating scale. In the nine years since she started her business, one or two parents have come to her for care because of her score, she said.
She always recommends parents check the state’s QRS provider listing because those day cares tend to be connected with local experts that increase the quality of care, she said.
The process of meeting the rating requirements helped Ausman find a network of Iowa child care professionals that she’s come to rely on for advice on subjects ranging from kids’ medical files to play room arrangement, which has been invaluable in her experience as a provider, she said.
“I’m a strong believer that a quality program will have involvement with other programs that help ensure you stay a quality program,” she said. “The QRS has forced me to connect with people.”
Costly and cumbersome
However, some child care providers say the application process itself is to blame for lagging participation.
The Academy of Early Learning in Coralville used to participate in the rating system but stopped applying partly because the paperwork was too cumbersome and time-consuming, said Amy Hilleshiem, center director.
Her center also couldn’t afford the financial burden imposed by the training the system requires, Hilleshiem said, since center directors have to pay for both the training and staff’s wages while they take the course.
Providers receive a bonus for their participation that ranges from $400 to $4,000 depending on its type and rating. This doesn’t cover the costs most day cares incur in becoming QRS-rated, but it’s what Iowa DHS can afford, Robinson said.
But Hilleshiem said many of the trainings focused on providing a certain number of toys or a specific range of activities for kids, which wasn’t practical or valuable. Plus, the application in its current form has no way to measure the quality of staff-child interactions, she said.
“You can’t determine a quality center on paper,” she said.
A focus on progress
About two years ago, the Iowa Quality Rating System Oversight Committee began redesigning the state’s quality child care rating system.
Committee members do not have a firm deadline for its rollout because they want flexibility to seek out more research and feedback when needed, Robinson said, but the new system should be implemented within a few years.
The system will be renamed the Iowa Quality Rating and Improvement System (QRIS) to emphasize the importance of professional progress, Ehlert said. It also will require providers to build on existing skills, she said.
“We should never get comfortable. We always have to be focused on making improvements and doing better,” said Vicki Williams, oversight committee member and director of Oak Academy, a licensed child care center in Des Moines with a five QRS rating.
The new system also aims to reduce redundant paperwork for certain day cares and push providers to be more well-rounded in their trainings, Robinson said.
Some of the enhanced rating requirements may be more difficult than the current system, but asking providers to work for quality is better for parents, communities and children in the end, Williams said.
“Yes, you have to do a little bit of work. Is it impossible? No,” she said. “But if it’s about quality, is it supposed to be super easy?”
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QRS participation rates
Child care providers at level 0 are either ineligible to participate in QRS or didn't apply during this application period.
Source: Iowa Department of Human Services