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?