 Good afternoon for those of you watching on YouTube. This is the Vermont House Human Services Committee, and it is Wednesday, February 17. And as part of our discussion and markup and around H171, a bill related to the title of which is an act relating to the governance and financing of Vermont's child care system. As part of that, we have asked various members of the Department of Child CCD, Child Care Development, right, Division, to answer, to help expand our understanding and knowledge. And so we have a bunch of questions that just sort of some information and we started out with, can Melissa, I think you're the person. Um, could you either refresh our memory or explain a little bit about the stars program and how that impacts with child care. Sure, absolutely. Good afternoon. I'm Melissa real Garrett. I'm the policy director for the child development division. And thanks for the question, Madam chair. Before I get started. Is it okay if Miranda and Sarah my partners in crime, get themselves on the record as well. Oh, absolutely. And wonderful. Miranda, I don't believe in testified in front of the committee before. Melissa has as has era. And sometimes it can be a bit of a free for all. So there may be questions and so Melissa phone a friend. And thank you. Thank you for the record. My name is Miranda Gray. I'm the interim deputy commissioner for the child development division and would like to thank you all for having us here to be able to testify today. We appreciate the opportunity. And Sarah truck all DCF financial director for the record. All right, thanks. So, I did prepare PowerPoint presentation, given some of the questions that you had already sent along to us and if you don't mind I don't jump. I don't start right with stars but if you don't mind me just sharing my screen and getting there when I get there I'd, I'd love to do it that way if that's okay with you. That sounds, that sounds fine. You are the expert in this. Follow your lead. Perfect. Alright, hoping technology is my friend and you all can now see the PowerPoint. All right. I think we've gone through this. So I will keep moving. These are the pieces and the questions that I understood you all to be interested in today. And as I said, hope to move through them in such a way that this all makes sense. I'm also planning to weave in where there are intersections with the proposed bill h 171. I feel pretty flexible in terms of fielding questions as we go along. We have multiple slides for each one of these topics and so there may be sort of a natural stopping point after each topic areas so people have questions. We can go ahead. Melissa. I was just gonna say we're seeing, we're seeing your notes as well I don't know. I don't know what you have coming up so I just am alerting you to the fact that we're seeing your notes. Yeah, it needs to be present presentation mode, not so that we can't see the notes. Okay, let's see if we can do this. And for committee members it is on our webpage. Miranda is actually offering to share it from her screen. So that you all can follow along from her and then I can follow my notes. And that sounds like, you know, I don't. Great. I don't put the notes in such great, you know, public view would probably not be a good thing. So this will be this will be much better. Let's see if Miranda can get it up. Perfect. Lovely. All right, let me reduce you all. And get to my screen. And we will be set to go. So I'm on slide to Miranda. And as I said, I'm happy to pause after each section to take any questions that you all may have. Go ahead and go to the next slide. I thought it might be helpful actually to start just a little context setting. We typically look at the CCDF law and rule as the source of the funding that that comes to us to fund our childcare subsidy program. But in reality, it covers a much broader territory than that. And these eight areas are actually the categories in which this law covers and requires states to implement activities underneath. But so each of these aspects are really interconnected with the other. And we have a fairly integrated approach as we address them. And so you asked some of what I'm going to be addressing today is the childcare financial assistance program. That's number three on the slide. Number four on the slide and actually number eight on the slide. But then in addition to that, we'll also cover some pieces of number seven, which is the quality rating improvement system and for Vermont. That is the stars program. So I thought you all might like to know that all of these pieces and aspects of our work actually flow from this federal law. I also wanted to talk a little bit about how we interact with the federal government. Each one of these titles is actually a category and what we call the CCDF state plan. And that plan serves as a contract of sorts between us and the federal government. We're required to submit that plan once every three years. And we're actually about to submit one. We have a new plan that's due in July this summer, and we'll go into effect on October one of this year. And interestingly, the term plan is actually a bit of a misnomer. We are not sharing with the federal government our hopes and dreams for these areas of work. We are our goals or any of that. Instead, we are simply reflecting to them any policies procedures and practices that we implement in order to be in compliance with the law. So therefore, yeah. Sorry, Melissa. Who do we ask to get a copy of that of the existing plan and the draft of the ongoing of the plan that you that's going to be submitted for July. Yep, I think that the PDF that was presented to you has the link to our current plan right at the bottom of the slide. And so that's that's where you could find the existing one. And then as we begin to frame up the new one. I'd be happy to share a draft of that with you. There's also a public comment process for that plan development. And so when we get that plan ready and posted for public comment, we also hold a public hearing. We'll make sure that this committee is informed of when that is as well. Thank you. And perhaps I should direct this to Miranda as the acting deputy commissioner. I think I speak for all the members of the committee that we would be happy to work with you. As you are developing this as contrasted to just commenting when it is done. I really appreciate that, Miranda, sorry if I'm jumping in for you, but as I said, this is actually just reflecting what we currently do. So I'll just give you an example. When you all update the federal poverty level or our market rates. We actually have 60 days to go in and amend our plan and reflect that policy change that you've put into law for us on our behalf. Another example is if we in September, we had changes to our center based childcare and preschool program regulations that we went through rulemaking and those were effective September of 2020. We had 60 days to get into section five of the plan and amend that to reflect exactly what that rule change looked like. So when you read, if you want to get into the plan that I provided it to you, because we have to stay current on our current practices, when we create our new plan. So really you're almost looking at a rough draft of it, as it exists, because we have to be current on our practices it's what will go into it so happy to receive your feedback. As you read through that, if you can flag areas where you feel like we're not reflecting what is actually happening in practice in the state. Thank you Melissa, sorry to interrupt. No, it's good. I'm happy to happy to do it this way. I'm ready to go to the next slide Miranda. All right, so I did want to just talk a little bit about what is being proposed in each 171. And what the impact is on the federal requirements coming from this law. The first place that I see an intersection is each 171 section five and the idea of using the cost of care as a benchmark for setting rates, rather than the market rate methodology. So, actually, cost of care is an alternative methodology that requires office of childcare approval in order to use. It's something that is, is just allowable for us to do. So, if this move forward, we would need to essentially apply to be able to use that methodology. And then there's pretty extensive criteria, and we wouldn't actually be able to implement it until we received office of childcare approval for using it. I did want to just flag that that a July 1, 2021 implementation date might be difficult. If, if this is in fact the direction this committee would like to go because getting that office of childcare approval does take a little bit of time. And in general, it's not really a way that is being utilized nationwide for establishing and setting market rates are our rates that we are paying. And there are, I reached out to my federal program officer and request some information about this. And she did say that there are four states that the office of childcare is aware of that are proposing an alternative methodology those states are Colorado, New Mexico, Delaware, and Washington. So, there's also a second rule that's part of the CCDF law that interacts with this particular section. And that's actually the requirement that we can't pay a provider more than they are charging private paying families. So in other words, they need to set a tuition rate that is the same for all families in their program. And then they tell us what that tuition rate is. And we can pay up to that tuition rate. Above it. And why that's important when you think about switching to the true cost of care as your benchmark is because right now in this world in 2021, the, the financial assistance program families make up about 20% of the families utilizing care. So you have 80% of other families out there that are private paying families and the true cost of care certainly is much higher than it would be. If we are looking at what the market is currently charging, which is what we what we are now using for a benchmark. And if programs decided to go ahead and charge that to families, the other 80% of families in the system, potentially could run into an affordability issue, trying to access care. The flip of that is programs will recognize they would price themselves out of the market, and just wouldn't actually even be able to tie their rates to the true cost of care. And finally, I'll just share with you. We don't ignore a true cost of care when we set the rates that we set. In fact, and this is hot off the presses and kind of excited to say this, the 2019 Market Race Survey report has just been published. And I'd be really excited to come back and walk you all through the highlights of that report. But part of that report is a new section that is in fact an analysis on the true cost of care for Vermont programs. And that analysis is able to provide us at least a reference point, as we set rates. So, lots to say about that one. Thank you. Thank you, Melissa. Just so that I'm clear. Are there other for states are doing actual cost of care. Does that mean all the rest of the states are doing a similar way as we are, or are there alternative ways that are. Do we have a choice? I mean, this is the federal government layout. You could do a B or C, but you have to get permission for E F and G. Right. They lay out that we can tie this to the market rate survey. And then if we would like an alternative methodology, there's a pretty extensive criteria and I'd be happy to send you the link to that criteria. So you need to demonstrate in order to get approval on alternative methodology and cost of care is one of those methodologies. But the feds only without having to ask permission and demonstrate they, they only say market rate. That is correct. Thank you. All right. So, the next section where there's some interaction with CCD ask requirements is section six of each 171. And that is where they are asking that a state plan amendment be required. And as I mentioned a little bit earlier, the federal government actually requires state plan amendments anytime that there's a policy rule procedure or implementation change to the work that we do for them. So the putting into law the requirement that we do a state amendment, a state plan amendment is actually duplicative. And there is a little bit of a concern that if at some point, federal rule or law changes around the areas that have been legislatively required as to be part of our plan that we might be out of compliance with the federal requirements until we actually got state law change. So it just is a little bit confounded the bill itself can achieve and you all can achieve the policy goals within the bill without legislating that we do a state plan amendment. And we would need to do a state plan amendment within 60 days of implementing those policy changes, because that's what the federal government requires. So I'm sorry, Melissa, we have a question from representative wood. Thank you madam chair. Melissa I just want to sort of say back to you what I think I understood with regard to that section six. So I heard you say it's duplicative so I interpret that as being not necessary. I want to make sure that I understood what you said that if it were, if we were to put something like that in law, and the federal rules changed at some future point. It could sort of put us out of compliance with federal rules, and by current federal rules, any changes that are made at the state level to the program, have to have a state plan amendment already within 60 days. Is that did I understand what you said. Okay, thank you. I'll also just briefly reference the policy in this section six, and I'm going to get into it a little bit later on in the PowerPoint, but the policy in this section is actually substantially different from the governor's five year plan for child care assistance. So if this does move forward this year it will actually take us off track from implementing the governor's plan. And like I said I will get into the details of that in a little bit of this PowerPoint. And then the final thing I will just note is that in section seven is really this intent around a family paying no more than 10% of their income for childcare. And while it's not actually as part of the rule in the in the rules preamble for the federal government, they actually set a 7% benchmark for copays. And so, while that doesn't actually hold they don't hold states accountable to that benchmark. It does speak a little bit to the need to determine if 10% is actually the correct benchmark, if that's the direction that we are headed. Right. That's actually the end of talking just in terms of the general overframing around the state plan next I was going to get into the stars program so are there any other questions just in terms of this. This section. Madam chair. I'm talking to you but I'm muted. I see your hand is up and is that for a new question. Yes, it is. This is just a quick question and Melissa, if you're not the person to tell us this, let us know who is but you, you referenced that the feds benchmark 7% as sort of what would be, I guess, best practice. Do you know if there are any other states who are actually achieving that. I don't know that, you know, there's actually national resource for us on this program. The national it's called the subsidy center. And they provide technical assistance to all states that are implementing this program. And that's where some of and a lot of my data comes from so I'd be happy to reach out and ask them that question. And mind giving us a contact there that would be that would be great so we can learn more about what other states are doing. Absolutely. Yep, I can do that. I think you can. All right. Perfect. We'll move on to the next slide. Okay, so as I mentioned before on stars is a piece of the CCDF legislation. We actually section seven of our state plan. And we pay for this system with the quality set aside dollars that are required by the federal government for this program. We were actually one of the first states in the nation to ever adopt a quality rating and improvement system. As you can see, it's really a way for providers to achieve recognition, going above and beyond the licensing regulations in their practices. So essentially providers achieve a star level by earning points in each of the four areas on this slide. And then we add up the points and depending on the number of points they have it equals out to a total number of stars. So we're in if you go to the next slide, we can see how that math works. So you can see here. Again, depending on how they've earned points in those areas on the previous slide reflects where they land at a particular star level. The way we do this and approach this structure is unique nationally. There's some pros and cons to it. So the pros of this structure is the flexibility. And there's really a lot of choice for programs in terms of how they earn those points and in what arena. The drawbacks really are in transparency for families to be able to know by a program star level, which areas they actually earned those points in. So, you know, to just say you're a four star program that doesn't necessarily mean that you've earned all your points in the program practices arena that are possible. And you, you know, that may be important to you as a family versus the administration arena. But there's no really there's no transparency right now in the system for families around that. As quality reigning and improvement systems have evolved nationally over the years. There are three main structures. There's a straight point structure. There's what's called a block structure. And then there's a hybrid structure of both blocks and points. And while we are a hybrid, we, as I mentioned, we're an anomaly hybrid. And so I will stop there and see if you guys have any questions in terms of how this program is currently operating. Melissa, I have two questions. One, how. And maybe this is coming later. How does the number of stars that I have relate to CC FAP. It is coming later. You're right. I will get there. And the, and the other is, I am not a center based program. I have whatever three to four kids who come to my home. Assuming I'm allowed to do that. So I am a family childcare provider. Is there any way that I could as a family childcare provide a family provider be a five star program. Yes. Okay. Thank you. Yep. Yep. Thank you. I'm going to go ahead and set in the stage for, I won't ask you for what you're going further. Sorry. All right. Very good. Awesome. I would love to just point out in the upper right hand corner, the new stars logo. And we, we used to use actual like number of stars. Like fear five stars, you literally have five stars on your certificate. And now we use this logo with the colored in points of the star. The reason why I mentioned that is because we really want to emphasize that the process of moving up through the star system. The process of reflecting on your work and the, and the intention of improving your quality is often as important as how many stars you've achieved. And we really felt like having a logo that had the five stars or four stars in a row made people think a lot about like hotel ratings or those, you know, those kinds of things. And it really isn't about consumer approval. Instead, there really are criteria that are predefined that programs are meeting in order to achieve this. And it is a pretty extensive process to move up to the system. Thank you. And representative Wood has a question. And I'm just going to say to the other members of the committee, please feel free to ask questions, even though two of us seem to be asking a lot. I apologize madam chair but no, I'm sorry. So Melissa, one of the things I was going to sort of let go by but then you know with the stars and the symbolism I actually like the symbolism there. And on the page that you're on right now it describes across all five areas but on the preceding, excuse me on the preceding slide there's only four areas so I'm trying to figure out what's the fifth area. Oh, I see what you're referencing so this is actually lifted directly from our website and we are in fact going to need to update it. And two will be patient with me in a couple of slides I'm going to get to a revision that we've done on this program and we used to have five areas we used to have the regulatory history arena, and we no longer have the regulatory history arena through rulemaking and had that arena removed in 2019 and I'll get to the rationale for that and how we got there in process. And just a couple of slides, but thanks for pointing that out and we will need to go back to our website and get things edited. Okay, so there are only four areas, right. Okay. That is correct. Yeah. Yeah, but you can still earn five stars by earning points within those four areas. All right, Miranda I think we're ready for the next piece. I thought I'd throw a little data in for you all. So part of that change that happened in September of 2019 that I just referenced actually made it so that all programs participated in stars that went to a compulsory system, rather than a voluntary system, and we changed it but if you are a regulated program in good standing, you are automatically a one star program in our system. And then you begin the active work of reflection and quality improvement in order to move your way up through the system. You know, you can see from this data, we do have the majority of our programs are at the upper end of stars and in fact over half of them are in the four or five star range. So that's actually really great. And also be asking yourself why there's a program that has no stars. And again that's tied to the being in good standing with our regulatory license. It is likely that this program has what's called a provisional license that happens to programs in two ways. It could be for reasons of non compliance, significant non compliance with our regulations. And this is a tool that enables licenses to really go in and provide extensive TA and support in hopes of bringing that program back into compliance. Or it actually could be a program that's on ramping into regulation. And it is fairly close to completing that application process. So that they were awarded a provisional status and allowed to start serving families, while the final components of their application to be a regulated program come into play. Thank you, Melissa we have a question from representative Brumstead. Madam chair, I was just curious. So you have registered licensed programs that are family childcare would you say that that number 1132 is truly what's out there how much of a you know, how many do you think just don't show up in your chart that are in Vermont for childcare places to have you're talking about folks that folks that are just non regulated programs. Any more than that and they would only be very small right I'm just it's hard to believe you know for the whole state of Vermont we have 11. I'm just curious about the number 1100 yeah. So it's actually impossible for us to know. There are many programs that exist under legal exemption by the law so you can serve to additional families that children of two additional families to your own and not need to be regulated and it's perfectly legal and acceptable in Vermont. But because they don't report to us. We are not aware of how many of those are actually out there. And then there are folks. There are other also legal exemptions for example there are a lot of rec programs that are serving school age children that are provided under that legal exemption. But again they're not necessarily reporting back to us on on a regular basis. And then there are some programs that operate illegally and again sort of the underground programs that we are aware of some of those. We monitor some of those. Some of those we pursue with cease and desist orders but for the most part we're not. I wish I could answer your question but I can't. No I understand and I just want to be absolutely sure I think I know the answer but is that I'm child care financial assistance program funds can only go to children I mean two providers that are on this list. So you're sending these are the 1132 in Vermont that can receive funds. Okay. That's correct. And we actually have roughly I think generally between 85% and 90% of our programs that do actually accept child care financial assistance programs. Children. Thank you. So they could have they could have one one child on childcare financial assistance. They could have 100% of that many of our head start programs you know 100% of the children that are attending their childcare are on childcare financial assistance program. So a slightly different structure for us. Other states such as Massachusetts run two separate regulatory systems with two separate standards for regulation. And only the ones that meet all of the federal regulations are allowed to take the childcare financial assistance program kids. And then they have very few health and safety standards that are established at the state level for the other programs. So we are a state that has a unified system and all our programs are under one licensing regulation system. Melissa for those you have. We have two more questioners first representative Redmond and following representative Redmond representative Rosenquist. Thanks madam chair, just to clarification the center based childcare preschool programs non recurring what what is that what is non recurring. Right. Those are places where children come for just short periods of time so think about ski area programs those are our most typical non recurring programs so parents are in town for a week and kids are there just for that week. They actually have a separate set of regulations that they abide by because of that so a great example of a reg that they wouldn't necessarily be a beholden to would be our immunization records because often these are kids that they only see for a week. And it would be hard for them to actually get and retain and report to us on immunization records. Thank you. Does that answer your question representative Redmond representative Rosenquist. Thank you one of them was on that non recurring but the next group down license family care homes. And it's a relatively low number and I'm just curious what is the rationale people just don't want to become licensed because it's more costly or what is it. They. I think it may have more to do with the size of the program so the difference between a registered family childcare home and a licensed family childcare home is that you can serve more children in the licensed family childcare setting. And typically you would have probably one more staff person at least that would be working with you to serve those kids. So some of it is just the desire not necessarily to expand your home to serving more children within that setting. So that's a lot of it but yes the regulations there are they are slightly more regulations for the family childcare homes and there are for registered. Okay so what what's the maximum number that a registered family care home just to register family care home is it for children or more. It's six children under school age. And then you can actually serve an additional four school age children during the after school hours or on school vacations. Thank you. Take it away. All right. Let's go to the next slide. I believe we're going to be able to address the chair's question at this point. So for month stars is actually a fairly high stakes program and by that I mean in a variety of ways. The higher stars you have the more financial assistance you have access to. One example of that is publicly funded pre-k so programs that are Act 166 in addition to other criteria for becoming a pre qualified program programs are required to be four or five stars or nationally accredited. And so you know that is access to the education fund dollars paid on behalf of families tuition for 10 hours a week. Then the childcare financial assistance program. We pay more on behalf of families based on the number of stars a program has achieved so right now the way that's built into our structure is it's called a quality differential. And we add quality differential payment of increasing amounts as a program has a higher level of stars. And then I'm just going to skip to the last bullet which is specialized childcare that's another program that requires that you are a three star program or above specialized childcare programs are programs where they are able to serve. Our children that are in protective services or have identified needs. So, you know with that there is a differential payment that's paid through our subsidy program for those children it's a 10% differential for each of the child children that you take that are in protective services. And then just in terms of definitions of high quality. There are many programs and reports that really look to stars in Vermont to define what's high quality childcare preschool and after school programs. So, ready to roll to the next slide. I think we're coming up on the end of our of our stars stuff. This is the last star slide. I think it was around 2015. Vermont received the early learning challenge grant race to the top funds. And part of that federal grant award required that states evaluate and validate their quality rating and improvement systems. Our results were published in 2018. And as a result of those studies. There was a community of folks that made up our evaluation team and we really felt like there were some significant changes that needed to be made to our system. And so we went ahead and made changes in two phases. The first phase was adopted in September of 2019 and that's what I referenced before, where all regulated programs with a licensing good standing are automatically at one star making this a compulsory system, rather than a voluntary system. But we also removed the regulatory history arena and went down to four arenas as part of that shift. And then we're working on phase two of the evolution. It's a much more involved phase. It's looking at both changing the structure of how we have, you know, established the system as well as changing the actual criteria that programs are evaluated against. And because that's such an extensive piece, we've been doing our due diligence in terms of working with stakeholders and going out for community feedback. And then really utilizing stakeholder work groups to create some of the support materials needed. We were on track for a hopeful rulemaking. We would actually be in rulemaking right now, except COVID hit. We did need to put a pause on that work. We were using so many stakeholders to help us move this work forward. And they, on a voluntary basis and frankly, as we've been, you know, doing the COVID crisis, our childcare programs have been right there on the frontline. And they've really had to make drastic changes to the way they do business in response to the health guidance and really relying on them as a volunteer structure. It hasn't been possible really to return to that, that mechanism. Again, so here we are in winter 2021. While we've paused now the work, we are paying attention to emerging research that's influencing the work that we've done. And we're trying to figure out how we embed that emerging national research and best practice on QRIS as we make these changes. Thank you, Melissa. And in staying tuned, we have a question from Representative Rosenquist. Yes, Justin, maybe you said something on this and I missed it, but your third bullet point there, something about, let's see. Yeah, the third bullet point there about all regulated programs with a full license are at one star. And yet if I look at the previous thing that shows these different homes, it shows 153 just registered family care homes that are one star. So I didn't quite understand our relation there. Well, what that means is that they are they are a regulated program. They're part of our licensed regulated system. And if I understand your question correctly, essentially, if you walk through that and Amanda Miranda, maybe helpful to go back to that slide seven for the committee to reference as we walk through this. But if you walk across essentially the 153 registered family child care homes are part of the regulated system. And they right now are at the one star level because their licenses and good standing with our regulatory with our regulations. And then there are 42 of them that have met the criteria for two stars, and so on and so forth. So as those 153 programs. Now have the decision to make about do they want to pursue achieving higher levels of stars, or would they like to stay at the one star level. I don't know if I understood your question correctly and if I addressed it. Well, I'm not quite but I mean maybe I'm just dense on this but it just seemed that the way I understood those registered family care homes. They were not fully licensed. That's could only have up to six children plus four school age kids. Okay, but they're within that other bullet of yours. It said that the actually say it that they would be one star approved. What was that prior. Sorry. Yeah. That is correct. So, I think it may be the regulated terminology rather than. See if I can do it regulated programs with a full license are in one store, one star so I've said it. You understand what I'm saying. I got it now. I think I got what you're saying now. Thank you for hanging in there with me. The full license reference. We refer whatever type of program you are on this list. We still talk about issuing you a license to operate and under that license. You are awarded one of these categories. So you might have an after school program license. You might have a licensed family child care home program license, or you might be a registered family child care home program license. So it's really, I think, confusing that we use that term but it is the way we look at it. Thank you. I think I guess it's just a broader use of the term license than I thought. Okay, thank you. You can you could almost in some ways substitute the term like certificate right. Instead of license and sort of think of it in that way like you're certified. But thank you. That's the way it works. Yeah. I have two more questions one from representative would followed by representative from step. Thank you madam chair. Melissa in in the stars program is are the criteria where I'm trying to get at sorry it's not very eloquently. The education levels of staff. How do they play into the different star levels. Yeah, in our current program. We actually have an arena that's called staff qualifications and annual professional development. And so there's a fairly complicated formula that you know that we use in order to arrive at it and essentially if you have a staff member that has higher level of qualifications and maintains a certain number of professional development hours a year. You achieve certain points in the staff qualifications arena. So it is one of those arenas that you can earn points in. And so if it. And I guess to get the max. My question is to do if you're going to get the maximum number of points in that arena. Does the staff need to be to greed. Staff staff with a degree, or is the continuing professional development. Is there a way to achieve maximum points with just continuing professional development. Yep, you are at a level of detail that I don't have on the top of my head so I will get that answer for you and get back to you. Okay, and then you referenced currently does that mean that you're anticipating changing that. Yes, so part of our looking at evolving the system and the criteria within it are really looking at shifting more to criteria that are actually like high level and product criteria, or even just a process of quality improvement. And this concept of the act of being reflective and having intentionality in your growth. One of the things that research is really finding on the national level is that that's the better backbone to a quality rating improvement system than a bunch of checkboxes based on, for example, what level of degree your staff has. We are actively looking at that. And it's possible that a new star system would not have criteria tied directly to a staff's qualifications. Thank you. Thank you, Melissa. I just wanted to piggyback on what representative would was just talking about those because when I looked at this slide the evolution of stars it seems more like a timeline. Then is there big changes afoot like you're sort of get that feeling like, okay, look at we're going to go through this and this and then we had to slow down and then we found out about the research and so it sounds like that's the big change of what you just talked about is that we're going to try and move maybe from these boxes checked inside of our centers to more of a system, you know, similar to what they're talking about in schools these days to which is. I can't even think of the word right now but in high schools we talk about it instead of a B and C we're moving to a different sort of language but like a proficiency based rather than a yeah, yeah. Absolutely. And I will say I have a whole another PowerPoint presentation that really takes a look at the validation and evaluation study results and the work to making these proposed changes and even delves into the details of some of these proposed changes and I'd be happy to try to see if I can pull over maybe a one pager for you that sort of just highlights, you know, where we're moving and even where some of this emerging research is influencing us even to course correct what we haven't even changed yet. You know, is an interesting piece of this work. Thanks. Melissa this your response to represent Bromstead may in fact address this but I'm very intrigued by that your last bullet emerging research and as a, in my other life I teach. You could send some links as to what that emerging research is that would be I think helpful, partly because part of this bill is predicated upon certain research as to. Absolutely. Thank you. I'd be happy to. Okay. I don't see any other hands right now. All right. I think that brings us to the third bullet area that I was hoping to cover. During Commissioner Brown's testimony for you on this topic last week. There were a couple of questions that were raised and so I am hoping in the next couple of slides to really address those pieces. So Miranda, we can move on to 11. One of the questions that came up was really around. Could we get more information on the child care financial assistant program eligibility. And what are the hours and are there a part time eligible hours. So, Essentially, with eligible hours. We do have a part time status. We actually issue a part time certificate. And you know, the way this works is you in theory. If you show a need for one hour a week of assistance and you meet the fight the financial eligibility as well. You would be issued a part time service needs certificate. We actually go the other way as well. We actually have a certificate for extended time. So we consider full time in our system 26 to 50 hours per week. But if you are a family that demonstrates a need for more than 50 hours a week. We actually have a certificate just for them that gets them more hours per week. So that was one of the pieces that was asked about. I'll also just say in terms of schedule. There really is no set hours where when that childcare needs to be delivered. So the idea of non traditional hours or schedules. It's really the family is a worded a certificate. And then, you know, the limit in our system right now around non traditional needs has more to do with the community. Offering those hours of care, not necessarily that our program, because our program doesn't restrict paying for non traditional hours. But there's some other pieces around program eligibility and each 171 and I was interested in actually sharing with you our CC FAP regulations. So it is the second bullet that's provided on this screen. And how are we going to do this. I'm going to share it with you. I wonder, Miranda, can you relinquish control and I can pick it up for a minute. We've got it. Right. About that. So I'll point out that our childcare financial assistance rules were last promulgated in the year 2009. So these have been effective service needs since the year 2009. We have several employment service needs in our rule. And that goes into pretty a lot of detail in terms of what that looks like and what it is made up of, but it does include self employment, start up self employment and seeking employment. And these are all really important to Vermonters as they may be trying to get back to work. We also have a training or education service need. And I think highlight here, because there are several approved training programs that I'll scroll down to in a minute but I do want to make sure that we put a marker here that it's participation in a program, which in the opinion of the commissioner is likely to lead to employment within one year after completion of the program. So what that means that it really is a training program. It doesn't necessarily have to be a degree program, as long as it can lead to employment within likely to lead to employment within one year after completing that program. And then I'll just let you all take a look at what these are for training, including, for example, high school, either through equivalency work through adult basic ed, or actual high school work study programs, non traditional or online training. So there's a lot of flexibility in our rules around this particular service need. And then we have quite a few service needs that are really related to family or child needs. So we have a special health need of an adult is one of our service needs. And this is where you would find if an adult in the family has mental health needs needs inpatient or outpatient treatment for those needs or for needs around substance abuse. For example, those all fall within this service need. And so that is also an eligible activity. And then we've got special health needs for children. We even cover parental leave and family leave. Finally, we have family support childcare as well as protective services childcare. I referred to our specialized childcare provider designation earlier. Families or children that qualify under these designations are served through those specialized childcare providers. In addition to being three stars, they also undergo other training and support for particularly dealing and supporting families and children with these particular needs. And protective services is where you find children, for example, in the foster care system. So I'm going to stop sharing. I'm going to go back to Miranda. And I can take questions here. If folks have them. Melissa, there may be a there may be two questions related to the past slide, because that's when the hands went up. I have one and I don't know whether you can answer this on, or whether deputy commissioner can or whether we need to wait for the commissioner but section two of the bill talks about the eligibility for the program for the childcare assistance and references current law and ads or to support the healthy development of their children and strikes the language family seeking employment shall be entitled for up to three months. And then the commissioner may further extend that period. I'm not clear. It seems like the additional language is consistent with the rules that you have. I don't know what the import is. In terms of the families are entitled to participate for up to three months. How that works. I mean, does that mean they have to reapply or is that shall we say a piece of statute that that has evolved over the years and we perhaps practice has changed it. So, as I reflected the, the seeking employment piece has been in effect since 2009. And all of those service needs have been there since 2009. So, yes. I don't know if you have a line with those service needs but I would say it also adding the language that's proposed opens you up even further, potentially to all children in the state. And I know Sarah Chuckle was doing a little bit of thinking on this one. So I don't know Sarah if you want to be my phone a friend and tag in. Sarah Chuckle DCF financial director for the record. When we were testifying on this, I believe it was last week. I think what Commissioner Brown was indicating is that by this added language and expansion, it would, it could potentially qualify all children and that would have a fiscal implication through that because it now doesn't have those limitations around tying to that service need that you see existing now. So it's the highlighting that that language would have a fiscal implication and and cost the program or money, which would be difficult for us to be honest to capture from a analysis perspective, because we don't know how many more children would come in under that under that additional language. Okay, thank you. And now we have a question from representative Bromsted. Okay, I think I'm not muted. I have a. Over the last couple of weeks I've been learning a lot about reach up and how difficult it can be for them to access childcare, because the type of childcare they need is outside of non traditional hours and most of the childcare providers that are available for those kind of are not registered or licensed because of many reasons but one of one of the questions that I as I'm listening to all of this is that if you are a non traditional, you're willing to open up a center that has non traditional hours for healthcare providers and and folks who work in grocery stores, 24 hour grocery stores places like that. And so you're the children that are coming are most likely going to be sleeping and maybe eating dinner, you know it's a very different kind of program than what you license for daytime education program and I wondered if you have thought about that in the stars program and in the licensing, whether or not there could be is there an easier process to go through when you are really providing overnight or late night type childcare to encourage people to consider it. So that is a question. There's a little piece of my mind that is triggering that we may actually address that currently in regulation. If we don't. The reason why it's niggling in my mind is because we are and have been sort of batting around and talking about that. So, I would say that's something I can get back to you on to confirm one way or the other, what the current status is of that. But it's a fair point. Thank you. And I think, you know what I just want to like qualify. I can hear my team in my head in the background, a little bit that sometimes with all these programs that we run. I'm not as close to them, but I'm not as close as the administrator of the program right the one that's actually responsible for implementation and the details of these are ones that are complex and difficult, the higher the level we get away from implementing them. So, it's possible my director of licensing right now would be answering your question very differently. I'll just, I'll just leave it at that, but it may come back to you with the reasons why we haven't addressed it. Thank you. And unless it's one that's a good question that representative Bromstead has asked and to sometimes our committee likes to get into the weeds. When perhaps as policy makers. We can be in the trees instead. Representative Wood. Well, as I go we digging man chair. I do have a question regarding actually follow up to the question you asked about the, the strike out of the three months period thing and the potential broadening for the development needs of the child that new language in there I don't have it up but something along that line. So, is I'm reading the regulations as I'm glancing through these regulations. It seems as though that for certain families, you do address the development needs of the child. When it looks like that there is, you know, perhaps a family services case open or some sort of absent the protective services childcare because that's, that seems pretty obvious but the, the, the number Roman number to be one I the family support childcare. It's like it's related to to that sort of broadened eligibility, but a bit narrower. Is that a true reflection. I mean, that seems to say that for certain at risk children that you would that you consider their application for childcare financial assistance, due to the, the risk of, of the, what's happening in the family and just trying to try to figure out if this section does or doesn't do with that language is trying to do. So, I'm familiar with certain and families that qualify for family support. It can either be because of a need based on the family. So, I'm familiar with some families that, for example, one of the parents goes to prison. And I guess that that places on that family while that member of the family is in prison has found them to be eligible for the family support childcare category, but it may also be, you know, other levels of stress. And this category is actually the process for qualifying for this is a pretty intimate process between the eligibility case worker, and the family is actually a family support case worker, and cases are actually brought before a team of folks in a region to really understand the circumstances of the family and the child, and in order to bring them in under this particular category. So it's definitely about risk. It's about safety. It's about health. Some of it is about economics. So those those kinds of things. It's pretty broad. It's pretty broad, but it, but it, I guess what I'm trying to determine. It seems as though the language in the draft bill is being interpreted as he as being even broader than this category. Is that correct. Okay. Yes. You could almost consider these two categories in the rule as the height, the high risk. Right. And so thinking about supporting that a healthy development on children that have some elements of high risk in their world. And then looking at that language in the law that's that's being proposed as Sarah truck old commented on, like, it really could apply to all children. And I don't know, I'm not an attorney, but I would definitely want to know, like, what is the, what, what is the reach of that language? Just so you know, like, what it is your, your legislating. The other thing is striking the seeking employment would also be worth perhaps getting some legal opinion on in terms of does that mean that that we aren't able to do the seeking employment eligibility, even through rulemaking. I was, I was trying to think about that in this regulation because this says for a period of one month and less extended by the commissioner and then in that current law, which is I think we added that section two years ago that little piece. We said that the maximum could be three months. So, Yeah, so that's worth thinking about thank you. Okay, we'll let you continue. Awesome. So the only other thing I wanted to, the reason why I provided all three references here for you all is that the information about program eligibility really is readily available, including in this family booklet that is created particularly with the lens of helping families understand what's available. So, just for you all to know that. All right, I think we're ready to move on the other question. That was asked last week was for a crosswalk between the governor's five year plan as it was presented in 2019 where we stand in 2021. And I'll walk you through this slide and there's also some other categories on the next slide. But the summary here is that there really been no changes to the substance of the policy proposal presented in 2019. There have been aspects that have been updated to align with current benchmarks and utilization information. But in essence, the strategies and the details here in row one, there really are no changes from the original proposal. And I thought I'd just take a minute to talk a little bit about what this is. I think the most interesting piece is it's a shift to setting a flat co-payment amount for a family. And in our current system, we issue certificates by child and we do have co-payments assigned per child. So this really mitigates a family's responsibility for co-payment to what the family can afford. We are looking at increasing the income guidelines. So having the bottom of qualifying for this program to be 150% of the federal poverty level and then having the top go up to 350% of the federal poverty level. And then we did, we would establish a rate to pay up to a cap rate and I will show you some of those in a couple of slides while still maintaining a tiered rate structure based on program quality. You know, as we look at setting this co-payment, it's not setting it at a percentage of family income. Our methodology is really looking at, we took into consideration things like the livable wage, the JFO's basic needs budget, and then thinking about after that, those thresholds, what amount of money does a family have available to pay for childcare? And then assigning their co-payment accordingly. And the more money they have to pay for childcare, the higher the co-payment, but we also set those amounts in bands so that families can see and anticipate at what income level their co-payment would actually go up. And it's a little bit of a nuance and I am, I apologize, getting into the weeds here. But at a 10% or establishing a percent of a family's income as the benchmark for what their co-pay should be set at, every time a family's income increases, they get a raise or whatever. They are potentially looking at an increased cost for their childcare co-pay and they may, you know, it may be a net zero. I don't know for sure because we frankly haven't really delved into that deeply and done that analysis. But I can tell you with our plan and the bands with which we established those co-payment amounts, we really did that with some intentionality so that not every wage increase would actually result in them having to jump to the next income category and the next co-payment set co-payment amount. So there are some interesting nuances and differences, fundamental differences between the approach we are taking with the governor's plan and the approach that's being proposed in terms of a 10% cap. So I'll just stop there for a second. I can sort of walk you through a little bit what some of those ramifications are in terms of H171. That would be helpful. I'm about to get into the weeds. One, I understand that with the movement to whatever stage three or year three of the plan, that the co-pay for families who are accessing reach up, childcare through their reach up, that that co-pay goes away. That's correct. Okay. I just want to confirm that. And the other is, we didn't know if it was going to make any difference, but four years ago, six years ago, we passed legislation that if you got a raise and you put the amount of the raise, shall we say into either an IRA type thing of retirement or education, that that would not count as increased income. So your co-pay would remain the same. And I'm curious if you have any information as to whether that's really made any difference. I think a little nicking in my head that you've asked this question before. And what we learned, it was either last year or the year before, is that there wasn't a great uptake of that policy. I think even in the single digits of folks that have taken advantage of that, but I'd be happy to go back to our program administrator and find out, you know, where we're at with most current data. And I guess in terms of the most current data, I'd be curious as to how many eligibility workers or whoever are working with the families actually know about that to offer it. I'll absolutely find that out. I don't know that level of detail. What I do know is that we have a fairly extensive training program when we onboard eligibility specialists. As you might imagine as you saw part of those rules, this can be a complicated scenario as you find families eligible for this system. So there's a lot of education, there's a lot of support. We also have two grant monitors that are experts on this program that go out and monitor eligibility specialists regularly and are in their polling files and checking that they have found correct eligibility for programs. So I will absolutely check and find out how this particular aspect is being promoted to families through those mechanisms. Because I'm going to assume that there is not an easy technical fix to if there is any kind of computer technology that is figuring out rates to begin with. Okay, thank you. So I'll just touch on a couple of the sections that are in each 171 that aren't completely reflective of the governor's plan. The first two are sections two and three. First of all, they're actually additional edits that are needed to section 3512 of 33 VSA to accurately reflect the governor's plan. And I'd be happy to provide that to you all, but just simply adjusting to the 150% of SPL and then in section three, the 350% of SPL isn't fully representative of the way this plan works. And then in addition to that, the timelines in these sections really need to align with the implementation of the updated information system. We do not have the technology to implement section two on July 1 of 2021. And if that technology goes into play as we expect it will on October 1 of 21, then the effective date of July 1 of 22 would actually be too late. So there's just some some timeline troubles there. And then as I mentioned earlier in section six, in addition to legislating that we amend the state plan being problematic. If the policy there is implemented as it's written. I do just want to say it is substantially different than the governor's plan. And I hope I've articulated why in my previous description. And then finally, in section seven, the intent language again is a variance from the approach in the governor's plan. And, you know, we do have some concern that the 10% approach could be unfairly weighted for people at either end of the income scale. And are really curious as to the up to 10% language and how and where are we determining the right threshold based on income level. So a lot of curiosity about that. Finally, and most interestingly, while we do not do this as part of the year three flip for the governor's plan. This 10% approach could actually work with the way that we've designed the governor's plan. So where I talked about setting a capped rate that I'm sorry where I talked about the set co payment for a family. We could look at that co payment amount. Also do the lens of, you know, is it capped at 10% of that family's income. There might be one strategy where we can get at both. There would be a fiscal cost to that, for sure. And that would need to be analyzed and looked at. But that's another way that that could be thought about. All right. Yes. Thank you for those specifics. Our goal is to take final action on this bill a week from this Friday. So what would be helpful is if you if if I'm saying this to you perhaps I should say this to the deputy commissioner, if we had the I think that we're necessarily going to do it. But so we have that as a discussion point, what the language would need to be to make as you pointed out to make things either work as consistent with the five year plan and such. Okay. Thank you. On slide 12. Is there a 13 and 14. There is. Miranda, if you want to flip to 13 it just. I think you went one too far. There we go. It just continues along this theme of elements that, you know, been updated to the plan to align with current benchmarks and utilization information. All right. And then I did want to share on slide 14 what those capped rates look like. So I do want to clarify that we were sharing with you here the full time rates. But we do of course have a part time rate as well as extended time rates. But the chart as you can imagine gets really busy. So we reduced it just so you could see here. And I did want to give you a little bit of a comparison to where we're at now. If you look in the one star license center column. For the infant rate. It currently our current rate is 210 a week. And so at this cap trait, we'd actually be going up to 270 a week. And then another example in the registered section down below a toddler a full time toddler in a four star registered program. And now is $175 a week. And in our cap system, we'd be going to 200 a week. So you can actually find all of our current rate online. If the committee's interested in that, I'm happy to send you the link to that on our website. Melissa, I realize I've lost something in translation. Okay, I lose it all the time. Rate caps in the five year plan. So is this year five as the existing I got a little confused with your description. Gotcha. This is actually about what happens when we make the flip. So we will be including we will pay. We've got three children in childcare infant toddler and preschooler. Depending on what the provider is charging for tuition. We will see them up to up to these amounts. Yep. And this is in year five and we're in year three now. And this will actually this will actually happen in year three. I'm sorry for the confusion in the title. We affectionately internally call this the five year plan. Yeah, because we did do projections out for five years. So, and I can see why that's confusing. We do have a question from representative would and just. I'm having a mid afternoon law. I have an infant. I'm in, I'm in a one star one star program. Is that 270 a week. Yes. Okay. Representative would I just wanted to double check my understanding of the column headings that refer to the percentiles 50th up through 90th percentile. Okay, those the. Well, maybe you could tell me what those are. That would be trying to interpret what they are. Absolutely. So another benchmark that the federal government sets for us as we set our rates is that our base rate should be at the 75th percentile of the most recent market rate survey. What that means isn't that we set our rates at 70% of that market rate, the average market rate. Instead, it means that families can access 75 out of every 100 programs. So it's more about, you know, the number of programs that are charging that amount. So when you see the 50th percentile at the base rate. This is the rate that would be being paid currently to that one program that's in provisional licensure. And then all the programs that are one star would actually be at the 55th percentile. The federal government has been so kind as to agree, based on our plan that the one star rate can be considered our, our quote unquote base rate for meeting their benchmark. So, so while we're. Okay, I'm sorry. Go ahead. I didn't mean to print out. No, what I was going to say is while we're not at the 75th percentile at the one star rate. Neither really is almost anybody else in the country that is serving all families. There are states that have rates that are set at the 75th percentile, but they have waiting lists for their program. Because just like us, there's limited funds to be used. So, this is one of the places where we actually got a corrective action plan for the last state plan cycle or for the current state plan cycle we're in. And what they ended up doing is saying any states whose base rate is less than the 25th percentile, we're going to put you on a corrective action plan. So, all the work we've been doing over the last couple of years to increase the rates in the system have increasingly got us higher in terms of our percentiles. In year three, when we make this flip when our technology system is ready to go. We will jump dramatically from hovering with many of these rates are around that 25th percentile to actually getting to this 55th percentile so it's really significant, and it's a big move. And it's, it's important. I just want to make sure I'm understanding because you know we often hear from advocates that over months only paying at the 50th percentile of the market rates. And the reality is there's there's really not many programs who are at that 50th or after this change is implemented that are at that and in fact you can get all the way up to the 90th percentile it depending upon the perceived quality of your program through the stars. Rating is that accurate. It is accurate and I will also say that most of our children that are in this program are actually at programs that are three four and five stars so the combination of the policies. Building this in as a quality differential has really incentivized families to choose higher quality programs to place their kids. It's also incentivizing programs to move up in their quality level. So it's it's been a successful policy for the state to implement this quality differential. Thank you. Sorry. May I speak madam chair. Absolutely. Thank you I don't know how to raise my virtual hand I will work on that. When you're the couple when you're the code when you're the code whatever it is. Thank you that makes me feel a lot better. I was just wondering if there was any financial questions that Sarah Truckel needs to leave testimony. Represent would do you have a financial question I see your hand. Sorry that was from before. That's okay. Anyone else besides representative would or representative Bromstead have a or myself have a financial question. Well Sarah thank you for spending part of your afternoon with us and now you get to go do something else exciting. I'm going to go pick up my children so yes thank you so much. I appreciate it. Bye bye. Okay. Bye bye. Thank you. Thank you. Deputy commissioner for bringing that to our attention. Committee do we have any. What what additional questions. We have a captive audience of the. Of these two fine people. From the CDD. Deputy commissioner do you have do you want to leave us with. Any comment or any. Anything. I just like to. Yes thank you madam chair and we just like to. Thank you for giving us this opportunity to be able to come and talk more about our systems and then just where there is crossover with the H 171 and we welcome any other additional questions you have. And information that we can share. Well thank you because this has been helpful to us. In terms of as we move forward and make decisions related to each 171. Representative Wood has raised her hand. Madam chair I'm just curious from the witnesses when they would be able to get back to us with the information that they said, since we're kind of on an accelerated time frame. That's more for the witnesses. Yeah, so let's let's articulate what they were. Thank you for that contact information from the. From the National technical assistance. National technical assistance people. A link or something to the emerging research that you referenced that was leading you to maybe make some changes. It seemed that anyway that might might support or not support what is in 171. Licensing requirements around. If there's any lessening of requirements to meet some of these stars if you want to just provide overnight or late night hours for, for, you know, families. Good job. A link to the alternative methods of payments I wrote down. I think that's a good idea. And language suggestions. Or the pieces that you. So that we have that as part of our discussion so that when we actually make some decisions. I mean, don't get nervous that 95 members of the house signed on to this bill. It doesn't mean that we won't make changes. But if we treat this as a draft, it might be a quite fine draft, or it might take more changes. I have I can say I appreciate, appreciate the invitation. Thank you. I think that this is more about representative would helping us out a little bit or at least me off cycle because the conversation between Melissa and representative would on the percentile. It's really interesting, but I only I think I get like three quarters of it so I'd love to be able to go over that again at some point and I think representative would knows it much better than me so that would be really helpful because this is a big, I think a big issue that we need to talk about and committee. Understand. And happy to do that with the committee, or with the individuals that are interested in that. I'm going to make phone a friend on that because you know it took a couple of people to help me get it. They may be helpful. Okay. Thank you. Thank you, both of you for spending your afternoon with us and I really think this will represent would as something as as I'm trying to wrap up representative would is not letting me. I just popped into my head that I know that I because I was looking on our on our website and Sarah Truckel had previously given us the example of this is what is up on the screen now is how it affects providers. And she had given us information about how it affects families, you know the the implementation of the $25 flat fee. And so I know that there's a chart someplace. There about that sort of that that gave examples of you know a single mom and two kids and you know what they paid now and what they would pay under this. So I know it exists already but I can't seem to find it if you could add that to your list to for us that would be great. And I promise ma'am chair I am done. Okay, and we will do that. Anyway, I will just say thank you. And either through testimony or other we I'm sure it will be in continued conversation. So thank you very much. Good afternoon. You too. This ends the. Thank you. Thank you this ends thank you. So this is the House Human Services afternoon meeting testimony. You