Health in State Plans: New York State - Child Care Aware ...



Health in State Plans: New York StateNotes from OCCThe New York Child Care and Development Fund (CCDF) plan for the period of June 1, 2016, through September 30, 2018 has been conditionally approved. A "conditionally approved" plan is a fully approved plan with conditions to be met based on your waiver requests, if applicable, and implementation plans for unmet requirements.Waiver requests for the following requirements have been granted for one year; if progress is made, it is possible that waivers may be renewed:Graduated phase-out (3.1.5)12-month eligibility (3.3.1)Payment practices and timeliness of payments (4.5.1)Supply building strategies to meet the needs of certain populations (4.6.3)Health and safety requirements for 10 topics (5.1.6a)Inspections for licensed providers (5.2.2b), inspections for exempt providers (5.2.2c)Ratios of licensing inspectors (5.2.2d)Child abuse and neglect reporting (5.2.2e)Professional development requirements (6.1.1) New York will be on a corrective action plan for the health and safety training provision (5. l.6b) starting October 1, 2016 and will have an additional year to achieve this goal. A formal letter that shows the extended timeline for implementing the requirement is due from the state administrator to the Office of Child Care (OCC) by August 27, 2016.OCC has not made a determination as to whether New York’s payment rates are sufficient to provide access to child care services for eligible families that are comparable to those provided to families that do not receive subsidies, as required by the Child Care and Development Block Grant (CCDBG) Act of 2014; OCC will prioritize review of payment rates during upcoming implementation monitoring visits. Section 1: Health in CCDF Leadership and Coordination with Relevant SystemsState Plan ConsultationThe state consulted with the Early Childhood Advisory Council (ECAC) on the state plan via multiple presentations and a convened CCDF Planning Day. The ECAC includes members of Head Start Collaboration Office, New York State Department of Health’s Division of Family Health, New York State Office of Children and Family Services (OCFS), New York State Office of Mental Health (OMH), Bureau of Early Intervention, and New York State Department of Health. Coordination with Partners to Expand Access/Continuity of Care In order to determine how to better ensure prioritization of services for children with disabilities, research has been completed on how other states prioritize and set rates for families that have a child with special needs; a special needs application has been drafted.OCFS helped produce an e-learning training for providers on the topic of behavior management and early intervention services. A video on “Early Intervention Services to its Child Care Website” was developed for parents seeking guidance concerning developmental screening: . OCFS is participating in a project led by the New York State Council on Children and Families titled The New York State Pyramid Model Partnership with other public and private agencies. OCFS participates in the Joint Task Force on Social Emotional Development that has been established by both the Early Intervention Coordinating Committee and the Early Childhood Advisory Council; they are developing a guidance document focused on the social-emotional developmental needs of young children, birth to 36 months of age.In support of children’s mental health and in collaboration with programs that serve children in foster care, OCFS has a public/private partnership contract with the Jewish Board of Family and Children's Services, which provides psychotherapy and coordinates services for 30 families with children birth to age 3 who have been placed in foster care and are court-referred.OCFS partnered with the New York State Department of Health, the state agency responsible for Child and Adult Care Food Program (CACFP), to strengthen child care regulations for centers on nutrition. Additionally, the state provided $250,000 through a competitive bid process to a not-for-profit organization that demonstrated the ability to implement this outreach initiative on a statewide basis. Child care resource and referral agencies (CCR&Rs) are required under social services law § 410-q to assure access to the United States Department of Agriculture's CACFP for providers in their service areas.OCFS collaborates with the New York State Department of Health, the New York State Council on Children and Families, other state agencies, and interested parties on obesity prevention in child care programs. These stakeholders helped promulgate regulations that reduce screen time, require physical activity on a daily basis, and set standards for nutrition.OCFS will work with the Department of Health to distribute brochures and information to all providers about the benefits of breastfeeding and breast milk that will also encourage and support women who breastfeed in written hard copies and on the OCFS website.OCFS will be partnering with the New York State Department of Health regarding procedures for providing information on and referring families to existing resources and services for health insurance and developmental screening.Collaborations will occur between CCR&Rs and special education services. In cases where parents seek child care for children with disabilities, CCR&Rs ask parents about any required services or supports, and they contribute their data to the state report on the number of parent-identified special needs requests so that the system can track demonstrated need for child care in this population. CCR&Rs also offer technical assistance and resources to providers related to children with disabilities in child care; they also work with the Bureau of Early Intervention to facilitate services in child care settings. Conversely, the Bureau of Early Intervention, Pre-School Special Education, and Head Start are partners that provide direct services to children with disabilities and their families. New York State indicated that it is in full compliance with emergency and disaster preparedness requirements of CCDBG. Section 2: Health in Family Engagement Through Outreach and Consumer EducationNew York State indicated that it has not yet provided all consumer education requirements of CCDBG on its website. Specific to health, the state must develop:Policies regarding the social-emotional/behavioral development and expulsion of preschool-aged children in early childhood programsResearch and best practices in child development, including social emotional development, physical health and development (particularly healthy eating and physical activity), and meaningful parent and family engagementInformation about the following programs for which families may also be eligible: Temporary Assistance for Needy Families (TANF)Head Start and Early Head StartLow-Income Home Energy Assistance Program (LIHEAP) Supplemental Nutrition Assistance Program (SNAP)Women, Infants, and Children (WIC) programChild and Adult Care Food Program (CACFP)Medicaid and State Children's Health Insurance Program (SCHIP)Individuals with Disabilities Education Act (IDEA) programs and servicesNote: Child Care Aware? of America has developed a tip sheet that has sample language for states to use to fulfill consumer education website obligations in these areas; the tip sheet can be found here. Existing consumer education materials include information on health insurance for children and families and early intervention services, as well as information on whether child care programs are allowed to administer medications to children while in care. According to the state, suspension and expulsion policies will be developed by September 2016. OCFS provides consumers access to information on health, safety, and other monitoring violations by child care providers. The state requires providers to post compliance history in their centers in addition to the records that are available on the state’s website. While inspection results are available on the state’s webpage, provider-specific information about health and safety, licensing, or regulatory requirements met by the provider, are not yet available on the website for legally exempt group programs. It also does not include aggregate information on the number of fatalities, serious injuries, and child abuse in child care settings.The state offers access to applications for health and health-related services, such as WIC, SNAP, TANF, and Medicaid on its webpage. It also links to other programs, such as CHIP and IDEA. While information is available, it could be better centralized and described on the state’s webpage in order to comply with CCDBG requirements. The state has partially implemented requirements on referring families to existing developmental screening services. The state indicates that planning between OCFS, the Department of Health Division of Family Health, IDEA Part C, and State of Health Marketplace is developing procedures to ensure that child care providers are able to connect children and families with health insurance, care and developmental screening and supports. By September 30, the state will ensure that information about insurance is shared with providers and CCR&R agencies. Procedures are still needed to provide families and providers information on Medicaid developmental screening requirements (EPSDT). Section 4: Health in Supply Building Strategies to Meet Needs of Certain PopulationsIn order to ensure that there is sufficient supply of child care for children with special needs or disabilities, New York offers a special rate for care provided to children with special needs. OCFS is currently reviewing the rate and is exploring how other states prioritize families of children with special needs to see if their current rate is sufficient. OCFS is working with CCR&Rs to establish data that shows need for these services. OCFS has posted orientation sessions for potential child care providers that address starting an inclusive child care setting. Section 5: Health in Standards and Monitoring Processes to Ensure the Health and Safety of Child Care SettingsAgeCenters CFOCCenters NYSFCC CFOCFCC NYS<12 months4:14:112:613-23 months4:14:1 (to 18 months); 5:1 18 months to 3612:6 (13-18 months)12:2 (19-36 months)24-35 months4:1-6:15:112:23 years9:110:1Maximum 7:112:24-5 years10:110:1Maximum 8:112:2Mixed ages6:1The state notes that it has only partially implemented the requirement to have regulations requiring provider training in the topics specified in CCDBG. The state requires 30 hours across nine broad topics. The law would have to change to specify the topic areas: Prevention and control of infectious diseases (including immunization)Prevention of sudden infant death syndrome and use of safe sleeping practicesAdministration of medication, consistent with standards for parental consentPrevention of and response to emergencies due to food and allergic reactionsBuilding and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular trafficPrevention of shaken baby syndrome and abusive head traumaEmergency preparedness and response planning Handling and storage of hazardous materials and the appropriate disposal of biocontaminantsPrecautions in transporting children (if applicable)First aid and cardiopulmonary resuscitation The state needs to revise existing regulations that cover when and how much health and safety training is needed by providers. Currently the regulations require providers to take a 15-hour health and safety course. The course itself will be modified to address all topics required in CCDBG and rolled out using a train-the-trainer approach through 10 specified regions of the state. New York StateNew York State will also develop a five-hour health and safety e-learning course open to all, including legally exempt enrolled providers that covers New York StateNew York State and federal health and safety requirements.New York State has health and safety requirements in some of the areas determined optional in CCDBG: nutrition, access to physical activity, screen time, caring for children with special needs, and the recognition of child abuse and neglect. Complete health and safety inspections are not conducted annually at licensed programs, but targeted monitoring inspections are conducted. New York is not yet able to meet the requirement to conduct unannounced inspections of licensed providers annually. The state will amend the statute and will need to allocate fiscal and human resources for monitoring. Annual inspections are not required of every enrolled legally-exempt program, so statute and regulations will be needed. The state has established ratios for licensing staff, though it has a target ratio. An assessment will need to be completed to determine resources needed to meet this requirement. New York State has no requirement for mandatory reporting of child abuse and neglect by enrolled, legally-exempt child care providers/programs or the agencies that enroll such providers; a statutory change will be needed in order to establish these requirements. Section 6: Health in the Recruitment and Retention of a Qualified and Effective Child Care WorkforcePer the plan:Title 18 of the New York State Codes of Rules and Regulations §§ 414.14, 418-1.14, 416.14., and 417.14 describe the training topics and the minimum hours of training required of all child care providers and staff. These need to be modified so as to be inclusive of the ten federal mandatory training topics.OCFS incentivizes legally-exempt family child care and legally-exempt in-home child care to attend 10 hours of approved training by offering an enhanced subsidy reimbursement rate. New York State’s training system has been aligned with the state’s Early Learning and Development Guidelines. One of the mandatory topics is principles of childhood development, which instructs on the importance of meeting physical, social, and developmental needs of children, including children with behavioral needs, special needs, promoting play and physical activity, behavior management and discipline, infant and toddler brain development and cross cultural skills. OCFS has supported development of two e-learning trainings on “Managing Challenging Behavior” from birth to 36 months—one module covers birth to 18 months, and another covers 19-36 months of age. The plan mentions that there will be a strong emphasis on staff wellness in the newly formed Child Care Aware Healthy Child Care, Healthy Communities New York State partnership. The group addresses health, obesity, and nutrition issues in child care programs. There will be research and the sharing of resources so that children in care have caregivers who have support for their health and DF quality funds support an annual evaluation of SUNY’s Medical Administration Training. OCFS has supported, and continues to support, the State University of New York (SUNY) to develop trainings to promote the social, emotional, physical, and cognitive development of children, including those related to nutrition and physical activity. Three online training sessions were recently developed in collaboration with the New York State Department of Health in support of new regulations on healthy beverages and USDA meal standards. OCFS also provides a training called “Obesity Prevention” that addresses physical activity, screen time reduction, and child nutrition.Section 7: Health in the Support of Continuous Quality ImprovementSupporting the development or adoption of high-quality program and regulatory standards related to health, mental health, nutrition, activity, and physical development is one of the six selected funding activities for quality set-aside dollars. Two other areas of note for health are the focus on supporting compliance with state requirements for licensing, inspection, monitoring, training, and health and safety and to support the statewide network of 36 CCR&Rs and the Early Care and Learning Council, the membership organization for the local CCR&Rs. Funding for health training: CCDF discretionary funds onlyFunding for CCR&R system: CCDF discretionary funds including infant, toddler, quality expansion, and school-age resource and referral set asidesFunding for health, mental health, nutrition, activity, and physical development: CCDF discretionary fundsCCR&Rs provide parents information on quality indicators, financial assistance, health/safety requirements, and complaint policies. Quality dollars support consumer education in health even during the referral and selection process.-9144007543800About Child Care Aware ? of AmericaChild Care Aware of America is our nation’s leading voice for child care. CCAoA works with state and local Child Care Resource and Referral agencies (CCR&Rs) and other community partners to ensure that all families have access to quality, affordable child care. CCAoA leads projects that increase the quality and availability of child care, offer comprehensive training to child care professionals, undertake research, and advocate for child care policies that improve the lives of children and families. To learn more, visit usa.. Follow them on Twitter @USAChildCare and on Facebook at usachildcare.00About Child Care Aware ? of AmericaChild Care Aware of America is our nation’s leading voice for child care. CCAoA works with state and local Child Care Resource and Referral agencies (CCR&Rs) and other community partners to ensure that all families have access to quality, affordable child care. CCAoA leads projects that increase the quality and availability of child care, offer comprehensive training to child care professionals, undertake research, and advocate for child care policies that improve the lives of children and families. To learn more, visit usa.. Follow them on Twitter @USAChildCare and on Facebook at usachildcare. ................
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