Child Care Quality Rating System in Milwaukee and

Waukesha Counties

Team Members: Kristin Anderson James Beix

Benjamen Jones Bridget Gnadt

2009 Cohort 23 – Wisconsin Group

Executive Summary

• Development and implementation of a Quality Rating System in child care centers (QRS) – Partnership between regional preparedness

consortium and local public health agencies– Assessment above and beyond minimum

state licensing standards– Resulting in improved quality of care

Target Market

• Milwaukee and Waukesha Counties– 25% of State’s population– 34,000 children under age 5– Almost 700 group child care centers

• Milwaukee/Waukesha County Consortium for Emergency Public Health Preparedness– 14 local health departments

Needs Assessment

• Communicable Disease Outbreaks– Vaccine Preventable Diseases

• Measles, mumps, pertussis

• Poor immunization rates (54% of 2 year olds up-to-date)

– Gastrointestinal• E coli, shigella

Milwaukee/

Waukesha Rate*

National

Baseline Rate*

(3 yr average)

Magnitude of

local outbreak

2007 Shigella outbreak (children less than 5 years old)

253.5 15.25 > 16 times

2006 Mumps Outbreak 13.19 0.089 > 148 times

2004 Pertussis Outbreak 136.1 3.22 > 42 times

* All rates are per 100,000 population

Needs Assessment (cont.)

• Preparedness Deficiencies Survey– 83% claimed plans but 29% didn’t have in writing– Many plans lacked key areas such as: evacuation,

armed intruder, sheltering, etc.

• Child care interest survey– Majority of child care centers interested in QRS– Would be willing to pay for services

• Parent Interest Survey– Majority of parents would value QRS– Would be willing to pay for services at child care center

Definition of Plan

• Assessment– Criteria developed by Milwaukee Waukesha

preparedness consortium– Completed by RN through an onsite 2-4 hour

evaluation initially for City of Waukesha child care centers

– Findings taken to Milwaukee / Waukesha Consortium Board for scoring.

Definition of Plan (cont.)

• Second Onsite Visit– Within 1 month RN will discussing rating level

with child care director– Provide information on fee for service

activities available to improve rating level• Immunization Records Management• On-site Immunization Clinics• Emergency Preparedness plans• Education Programs for Families, Staff & Students

Definition of Plan (cont.)

• Posting of QRS Scores– Updated bi-monthly on the Waukesha County

Public Health website– Twice per year the QRS will be extensively

promoted through MetroParent Magazine.

Regional Phase in of QRS YEAR OF PHASE IN

AND REGION / CITY

YEAR 1

City of Waukesha

YEAR 2

Waukesha County (excluding City of Waukesha)

YEAR 3

Initial ½ Milwaukee County Suburbs

YEAR 4

Remaining ½ Milwaukee County Suburbs

YEAR 5

City of Milwaukee

CHILD CARE

CENTERS

30

148

64

95

379

Operations (cont.)

• Human Resources– 2 full time RN’s initially with an additional full

time RN hire each year in years 2-4– Part time (20 hours per week) administrative

assistant hired in year 2– By year five an additional 6 full time RN’s will

be hired to reflect the number of potential participants as all of Milwaukee and Waukesha counties are phased in.

Operations (cont.)

• Waukesha County Public Health Division – Fiscal Agent– House staff– Managerial

• Information Technologies– Laptop for each RN with internet and e-mail– Signature pad for on-site immunization clinic– IT support from Waukesha County under Public

Health contract

Operations (cont.)

• Measures of Success– Predicted number of participants complete

QRS assessment (79%)– Annual increase in the average rating level– Goals for 1st Year:

• 80% NAEYC approved curriculum • 80% utilize on site trainings• 80% Up-to-date immunization records• 75% Comprehensive Emergency Plans

Operations (cont.)

• Evaluation and Quality Improvement– Annual evaluation by child care centers – Specific program evaluations– Milwaukee / Waukesha consortium board

approves all QRS program changes

Industry Analysis

• WI does not currently have a QRS program.

• Many other states have successful QRS programs– North Carolina’s Star Rated License– Iowa QRS– Oklahoma’s “Reaching for the Stars” program

Marketing

Commercials during “Supernanny” and the WISN morning news will begin in

program year 3

The marketing strategy will be multi-phase, targeting both child care centers and parents

Marketing will initially focus on child care centers and will later shift to parents to create a parent-driven program

TimelineTime Frame Activity

November 2009 • Proposal for grant funding due to Healthier Wisconsin Partnership Program

March 2010 • Notification of grant award

• Begin staff hiring process

• Work with M/W Preparedness Consortium to develop preparedness criteria

July 2010 • Staff officially hired

• Purchase start-up equipment and supplies

• Staff attend trainings

• Initial group of child care centers are notified of project (City of Waukesha)

•Begin 5-year implementation plan by region

Competition and PartnersCompetitors• National Accreditation Program

• Continuing Education Providers

• Childhood Vaccination Providers

Partners• Milwaukee/Waukesha Consortium

• MetroParent Magazine©

• American Red Cross

Risks, Regulations and Exit

Risk• Failure to obtain grant

• Political will to launch program

Regulation

Exit Strategy• Incorporate into Nonprofit Org, type 501(c)

(3)

Year 1 Budget2010 Expenditures and Revenues

Expenditures Q1 Q2 Q3 Q4 Total

Total Personnel $27,305.00 $27,305.00 $27,305.00 $27,305.00 $109,220.00

Total Equipment $18,330.00 $150.00 $150.00 $150.00 $18,780.00

Total Other $28,261.48 $3,977.80 $4,565.80 $7,337.80 $44,142.88

Total Expenditures $73,896.48 $31,432.80 $32,020.80 $34,792.80 $172,142.88    Revenue Q1 Q2 Q3 Q4 Total

Healthy WI Partnership $150,000.00 $0.00 $0.00 $0.00 $150,000.00

Onsite Trainings $3,120.00 $9,360.00 $9,360.00 $9,360.00 $31,200.00

Record Management Fee $801.00 $801.00 $801.00 $801.00 $3,204.00

Immunization Clinic Fee $1,818.00 $2,727.00 $2,727.00 $2,727.00 $9,999.00

Home Preparedness Kits $0.00 $2,720.00 $4,080.00 $4,080.00 $10,880.00

Hosting LPHA (in kind) $2,469.00 $165.00 $190.00 $165.00 $2,989.00

Total Revenue $158,208.00 $15,773.00 $17,158.00 $17,133.00 $208,272.00

Net Difference $84,311.52 ($15,659.80) ($14,862.80) ($17,659.80) $36,129.12

5-Year Budget

Expenditures 2010 2011 2012 2013 2014

Total Personnel $109,220.00 $179,171.60 $235,346.75 $293,207.15 $606,803.36

Total Equipment $18,780.00 $56,975.00 $74,124.00 $102,058.70 $227,675.87

Total Other $44,142.88 $68,368.50 $79,054.60 $82,443.05 $147,079.13

Total Expenditures $172,142.88 $304,515.10 $388,525.34 $477,708.90 $981,558.37

   

Revenue          

Healthy WI Partnership $150,000.00 $150,000.00 $150,000.00 -- --

Onsite Trainings $31,200.00 $183,300.00 $249,600.00 $315,900.00 $704,600.00

Record Management Fee $3,204.00 $18,000.00 $24,400.00 $30,800.00 $68,800.00

Immunization Clinic Fee $9,999.00 $57,675.00 $78,438.00 $99,201.00 $221,472.00

Home Preparedness Kits $10,880.00 $63,960.00 $87,080.00 $110,240.00 $245,840.00

Hosting LPHA (in kind) $2,989.00 $6,507.00 $8,273.00 $10,045.70 $20,078.87

Total Revenue $208,272.00 $479,442.00 $597,791.00 $566,186.70 $1,260,790.87

Net Difference $36,129.12 $174,926.90 $209,265.66 $88,477.80 $279,232.50

Thank You!Questions?