Ohio should follow the science on lead poisoning and commit to a prevention-first strategy for all centers and homes licensed to provide child care, Groundwork Ohio recommended in a report released Tuesday.
The non-partisan advocacy organization took a comprehensive look at the state’s challenges and possible opportunities for reducing or eliminating exposure to lead, a brain damaging toxin that can cause delays in early childhood development.
State regulations currently call for child care settings to be lead-free, but health officials only respond after a child is poisoned.
A key “next step” – after making a commitment to preventing lead exposure – is figuring out the potential scope of the issue, particularly child care in private homes, says Lynanne Gutierrez, policy director and legal counsel for Groundwork Ohio.
That would include gathering data on the number of licensed child care centers operated in homes built prior to 1978, when lead-based paint was banned for residential use in the United States. Stand-alone centers, which operate out of commercial spaces but are often more highly regulated by local officials, could be assessed separately.
Gutierrez said the date might help officials and advocates figure out what it might cost to educate and financially support providers so they could meet any new standards created.
Hurdles for child care providers, of which Ohio already has too few, have multiplied as their businesses went into freefall earlier this year due to the coronavirus pandemic. Child care providers were shuttered for several months by state health orders, and when they reopened, it was with reduced enrollment and new rules to help prevent the virus from spreading.
While some providers have stayed afloat with a combination of federal and state subsidies and loans, many have shuttered at a time when parents are seeking child care so they can return to the workforce.
At the same time, Gutierrez said, issues like lead poisoning and racial justice are intersecting as children spend more time than ever in their own homes or with child care providers.
The report was produced in part because there wasn’t another resource that examined the issue comprehensively anywhere in the country, Gutierrez said. One important insight, she said, was that simply layering on additional regulation could be counterproductive or even harmful to an industry already under-supported and stretched to meet increasing state-mandated quality standards. Significant changes would require an infusion of resources, she said.
Gutierrez said child care professionals should be viewed as partners in the work of eradicating childhood lead poisoning and assuring kids get the best early childhood education.
Cleveland’s Problems And Progress
Childhood lead poisoning in Cleveland has far outstripped the problem elsewhere in the state, with tests for more than 24 of every 1,000 Cleveland children in 2016 revealing elevated levels of lead. That's compared to nearly 8 per 1,000 children statewide.
Last year, more than 1,100 Cleveland children under the age of 6 who were screened had levels of lead in their blood that required intervention, according to Ohio Department of Health records.
The city has made some of the biggest strides toward prevention in recent years, though.
The role of child care centers was raised by advocates championing “lead safe” legislation in 2019, but the issue was ultimately deemed too complicated to address on a local level in a timely manner. The legislation that was passed, without including child care centers, aims to make Cleveland free of lead hazards starting in March 2021.
The Lead Safe Cleveland Coalition, one of the groups working on the lead poisoning problem, promised to keep working on the child care issue, which included commissioning the Groundwork Ohio report after it could find no comprehensive resource on the topic.
It was an effort spearheaded by Billie Osborne-Fears, director of Starting Point, who spent most of her nearly 40-year career in public service as an advocate for early childhood education and development. Fears died after a short illness last month, and the report is dedicated to her legacy.
The coalition also worked with county officials to identify and reach out to 271 home-based child care providers in Cleveland who might fall under the city’s new “lead safe” rental laws. In June, the coalition sent out letters and emails to the providers with a fact sheet on lead poisoning, information about the newly required inspections and resources that might help defray any costs associated with complying with the law or remediating lead hazards.
Guidelines Murky Elsewhere
Ohio isn’t the only state with murky guidelines intended to prevent lead poisoning among children in child care settings.
Ohio’s current laws and administrative guidance signal the intent to keep children safe from the brain-damaging toxin, but in practice the licensing process requires only a visual inspection for cracked, chipped or peeling paint by a person with no special training to identify lead risks, according to the report.
In addition, not all in-home child care centers are required to be licensed and inspected, including providers that serve six children or fewer, unless they receive public subsidies.
Nine states require an inspection by a certified lead risk assessor before a child care center can get a license: Connecticut, Delaware, Idaho, Maine, Maryland, Mississippi, Missouri, Oregon, Vermont. Other states require action only after a hazard is found at a licensed child care facility.
Last year, Ohio started to look into the current licensing process, according to LeeAnne Cornyn, director of children’s initiatives for Gov. Mike DeWine. While that review was underway, the state advised child care licensing specialists who spot potential hazards like peeling paint to refer the providers to local or county health departments, or another agency that could help properly assess the problems.
While those interim changes are welcome, according to the report, they will require follow up to determine whether health departments have the capacity to provide additional lead risk assessments and to identify available assistance for helping centers that need to remediate hazards.
Providers are not encouraged to scrape or repair lead paint on their own because it can cause more lead dust to be released and create a bigger hazard if not done with proper safety precautions.
Cornyn also said a Lead Advisory Committee appointed by DeWine would examine the issue of lead hazards in child care settings. A draft copy of the recommendations, set to be released soon, does not include new standards to prevent or detect lead hazards in child care settings, but does call for increased education for parents and providers.
Additional education is important, Gutierrez said, but without support to shore up struggling providers, it isn’t enough.
“Surely if more providers knew about this, I don’t think they would sleep on it,” she said. “You’d be hard pressed to find someone who wouldn’t be in crisis mode about [a child being poisoned.]”
