The Empower Program – A successful application of State resources to improve Arizona child care

environments and improve the lives of Arizona children and their families.

1

Introductions Bonnie Williams, MA

Early Care andEducation Manager,Bureau of Nutrition andPhysical Activity

3 years withBNPA/ADHS

30+ years in Early Careand Education

Empower stakeholdersince inception

Flossie A. Wagner

State Licensing Surveyor,Bureau of Child CareLicensing

15 years withBCCL/ADHS

Empower DevelopmentTeam member sinceinception

2

Conception and Implementation

3

Empower Program history/synopsis

4

http://www.azdhs.gov/documents/prevention/nutrition-physical-activity/empower/empower-healthy-opportunity-for-az-children.pdf

Program development On November 16, 2009, new fees announced for all licenses

Empower pilot program introduced concurrently

Participation was voluntary for all licensed facilities.

If registered, licensees were entitled to a reduced licensing fee (50%) at the time of renewal.

By implementing the identified best practices, the following discounts were available:

Capacities of 60 or more children reduced fees of $7,800 to $3,900;

Capacities of 11-59 children reduced fees of $4,000 to $2,000;

Capacity of 10 or fewer children reduced fees of $1,000 to $500.

5

Community response Acceptance of the program by the child care

community was overwhelming.

Arizona child care licenses are renewed every three years.

In the first six months, 403 facilities enrolled

Only 5 declined enrollment

1,427 additional facilities enrolled even without a license fee due immediately

Empower became a permanently funded program at ADHS in 2012.

6

Partnership & the Bureaus

Arizona Department of Health Services

Licensing

Bureau of Child Care Licensing

Regulatory foundation

Connections to child care

community

Direct contact with providers

(technical assistance)

Prevention

Bureau of Nutrition and

Physical Activity

Fee subsidy, brochures,

external resources

Bureau of Tobacco & Chronic Disease

Fee Subsidy, brochures/info

7

Positive Outcomes for ADHSBureau of Child Care Licensing

Bureau of Nutrition & Physical Activity

Fees fund the licensing and regulation process

50% paid by licensee

50% paid through Nutrition & Physical Activity grants, Tobacco & Chronic Disease funding

Access to additional resources for centers & homes

Opportunity to partnership with community

Increased access to children and their families

Opportunity to help programs improve practices relating to nutrition & physical activity

Data collected allows limited resources to be applied more effectively for long-term benefit

8

Positive Outcomes for ADHSBureau of Tobacco & Chronic Disease

Children’s Environmental Health

Increased access to children and their families

Opportunity to help programs improve outreach to families

ASHLine

Second-hand smoke & Third-hand smoke information

ADHS Public Health Preparedness Division is home to the SunWiseprogram

The Empower program allowed expansion of SunWise program dissemination to children ages 0-5 years

9

http://www.azdhs.gov/preparedness/epidemiology-disease-control/sunwise/index.php

Empower Program Includes “10 Ways to Empower Children to Live Healthy Lives,”

which is a list of best practices that child care facilities must follow to become an official ADHS Empower Center.

Standard 1: Physical Activity and Screen Time Standard 2: Sun Safety Standard 3: Breastfeeding Standard 4: Child and Adult Care Food Program (CACFP) Standard 5: Fruit Juice Standard 6: Family-Style Meals Standard 7: Oral Health Standard 8: Staff Training Standard 9: Arizona Smokers’ Helpline (ASHLine) Standard 10: Smoke-Free Environment

10

http://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.phphttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-physical-actvityhttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-sun-safetyhttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-breastfeedinghttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-food-programhttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-fruit-juicehttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-family-mealshttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-oral-healthhttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-staff-traininghttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-ashlinehttp://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.php#resources-policies-smoke-free-campus

11

Bureau of Child Care Licensing 23 Licensing Surveyors statewide

Over 2500 licensed facilities (centers, homes)

Required regulatory inspections:

Centers: 1 per year (annual compliance)

Homes: 2 per year (annual & mid-year compliance)

Other inspections done as needed

Monitoring

Complaint investigations

Modification

Unlicensed inspections – alleged unlawful child care12

Licensing Inspection Overview Physical plant

Building, playground & equipment

Administrative

staff and children’s files

records

management practices

Classroom Environment

Empower Standards

99% of licensed facilities are currently registered with Empower Program

13

Licensing staff functions Empower Assessments

Completed during the annual compliance inspection

Surveyors recommend that providers complete the assessment independently

Surveyors are available to answer questions, clarify Standards

Assessments are not regulatory – no punitive action attached

Surveyors ensure that data entry is completed for Empower Facilities

14

Assessment – data entryPaper form Direct online input

Generally paper is more conducive for regulatory process

Director can finish at her own pace

Surveyor can continue regulatory inspection

iPad used during inspection

Allows directors time to reflect, assess and come to a conclusion

Very convenient

Data is immediately loaded to digital storage

Assessments are not misplaced or forgotten

Frequently Surveyors will:

Enter data while on-site

Allow director to complete on iPad during exit interview

15

Empower Assessment form

16

Empower SurveyMonkey entry

17

18

Functions for Nutrition and Physical Activity staff Collect and analyze data

Coordinate resources

Provide training, training resources

19

Outreach functions Develop additional

community resources

Connect community resources with facility staff

Encourage implementation of best practices

20

Home Settings Licensed Child Care Group Homes (CCGH) (ADHS)

Training and/or technical assistance with almost 300 licensed homes over 2-year period

Provide resource kit to support nutrition education, physical activity and family-style meals

Certified Family Child Care (FCC) Homes (DES) Almost 600 FCC Homes must register with Empower as part

of new contract agreement with DES (Department of Economic Security) and FCC providers

Training and/or technical assistance for supervisory staff

Provide resource kit to support nutrition education, physical activity and family-style meals (supported with SNAP-Ed funds)

21

Updates to Materials Update of Empower Guidebook (3rd edition) in July

2016

Focus on standards, rationale and policy samples

Updated Empower Pack Kit (November 2016)

Copy of revised Empower guidebook

Copy of Active Play! (Dr. Diane Craft)

Updated collateral pieces such as magnets, posters, window clings and additional marketing and promotional materials

22

Updates to Website Keep website relevant and current

Moved Teacher Activities here from guidebook

Moved Family Handouts here from guidebook

Awareness of five ‘lenses’

Center and home settings

Children with special health care needs/disabilities

Language and cultural accommodations

Multi-age grouping

Family engagement

23

State-Systems Change Funding from Nemours Early Care and Education Learning

Collaboratives (ECELC) (Empower PLUS+) was impetus for intensive focus on obesity prevention

Sustainability goal grew from ECELC experience

Empower is compatible with ‘like’ quality improvement initiatives

Consistent messaging

It’s all about relationships

24

ECE System CoordinationEmpower is compatible with…

Quality First (FTF QIRS system)

Head Start/Early Head Start Performance Standards

ECE accreditation systems

AZ Early Learning Standards (3-5 year olds)

AZ Infant/Toddler Guidelines (0-3 year olds)

Teaching Strategies Gold and other assessment/ongoing progress monitoring systems

ECE curriculum approaches

25

ECE System ElementsArizona Department of Health Services (ADHS)

Bureau of Child Care Licensing (BCCL)

*Licensed Child Care Centers

*Licensed Child Care Group Homes (CCGH)

Bureau of Women and Children’s Health

*Material, Infant and Early Childhood Home Visiting (MIECHV)

Bureau of Nutrition and Physical Activity (BNPA)

*Women, Infants and Children (WIC)

*Arizona Nutrition Network (SNAP-Ed)

*Empower Program

Arizona Department of Economic Security (DES)

*Certified Family Child Care Homes FCC)

*Certified In-Home Child Care

*Arizona Early Intervention Program (AzEIP-Part C)

*Child Care and Development Block Grant (CCBDG)

*Child Care Development Fund

*State Plan

*DES Child Care Subsidy

First Things First (FTF)

*Quality First (QRIS)

*Other Initiatives and Programs

Tribes

*Child Care and Certificate Program

*Head Start/Early Head Start

Head Start/Early Head Start

*Regional Grantees, Delegates, Tribal, Migrant

*Performance Standards (federal regulations, local decision-making)

*Child Care Partnerships

Arizona Department of Education (ADE)

Child and Adult Care Food Program (CACFP)

*Alternative Approval Home

Early Childhood Education/Early Childhood Special Education

*Early Learning Standards (ELS) 3-5

*Infant Toddler Developmental Guidelines (ITDG) 0-3

*Preschool Development Grant (PDG)

*Preschool Special Education (Part B, Section 619)

Local Education Agencies (LEA)/Public Schools/Charter Schools

*various early education programs/free/tuition

*special funding/projects

Many other quality initiatives which may be local, state, national, international

Montessori

Faith-based

Professional Association (NAEYC, NAFCC, etc.)

26

Questions?Answers…

27

For further information: Empower website

Bureau of Child Care Licensing website

Bureau of Nutrition & Physical Activity

Bureau of Tobacco & Chronic Disease

Bonnie Williams

Bonnie.Williams@azdhs.gov

Flossie A. Wagner

Flossie.Wagner@azdhs.gov

www.AZDHS.gov

28

http://www.azdhs.gov/prevention/nutrition-physical-activity/empower/index.phphttp://www.azdhs.gov/licensing/childcare-facilities/index.phphttp://intranet.hs.azdhs.gov/divisions/phs-prevention/nutrition-physical-activityhttp://www.azdhs.gov/prevention/tobacco-chronic-disease/index.phpmailto:Bonnie.Williams@azdhs.govmailto:Flossie.Wagner@azdhs.govhttp://www.azdhs.gov/http://www.azdhs.gov/http://www.azdhs.gov/

November ECE Networking Call- Arizona Empower Program Audio

Blank Page