Child care centers struggle with conflicting advice during COVID-19 outbreak - North Carolina Health News

Note: This article has changed from the original to reflect N.C. DHHS further  guidance that childcare centers remaining open can take in children of critical workers, but do not have to. 

By Sarah Ovaska 

Darnella Warthen hoped to keep her Durham child care centers open even as the spread of COVID-19 prompted public schools, businesses and restaurants in the state to close for the foreseeable future.

The families she served, largely poor and some struggling with housing, needed her and her staff to watch their kids while they themselves worked lower-wage jobs.

But Warthen threw in the towel and shut down the four A New Beginning child care centers that she has on Tuesday, several days after the N.C. Department of Health and Human Services issued a set of guidelines for child care and day care centers. Centers wanting to stay open will need to not only adopt strict sanitation protocols but report vacancies to the state. Warthen also understood at that time that she must be willing to take in children of emergency and health care workers as a condition of staying open, which state health officials have since backed down from.

That was too much of a risk to take, Warthen said, for her teachers and staff already worried about the dangers of coronavirus. She and her staff had concerns if they had to care for different children every day from households with potential exposure to dangerous pathogens.

“We probably could have continued on a little longer had they not put those provisions in there,” Warthen said. “You’ve already got people working under very stressful conditions.”

Warthen’s experience is just one example of the confusion, pressures and challenges hundreds of child care centers around the state are facing, as they weigh whether to stay open to provide needed care to the front-line workers like health care staff or close to protect themselves and their staff.

The need to provide child care is a critical one in this pandemic, N.C. DHHS Secretary Mandy Cohen has said repeatedly in her regular public briefings on the response to COVID-19.  The state health department even set up a hotline – 1-888-600-1685 – to match parents with open centers in their areas.

Uncertainty shutters centers

What’s been less clear is whether the state or anyone else will pay for that desperately needed child care for front-line workers. Child care centers, many privately owned and often operating on razor-thin margins in the best of times, are unsure how to stay afloat financially or keep their teachers and children as COVID-19 spreads across the state. Late Wednesday, DHHS officials reached out again to child care and pre-K directors, saying the state would pay teachers an extra $300 and an additional $200 for other workers in April and May.  DHHS also plans on covering parent’s shares of child care subsidies as well as the child care costs for lower-income critical workers who can’t find other child care for the months of April and May, according to the newest DHHS guidance, issued Wednesday. The agency also clarified that it is not requiring open childcare centers to take in children of critical workers, but is urging open centers to consider doing so.

Nonetheless, many centers are still closing. DHHS officials told advocates Thursday, 55 percent of the state’s day care centers that serve babies through age 5 have already closed their doors.

Warthen’s center typically provides care to those with few choices. Almost all of the centers’ nearly 200 children come from low-income families using child care subsidy vouchers, face homelessness, or are involved with child protective services or foster care systems. Many struggle with the continual pressures of not having enough to make ends meet. Without child care, Warthen knew her families would have trouble working.

“That’s one of  the reasons why I wanted to remain open as long as possible,” Warthen said. “I knew my families didn’t fit in the other categories of being able to stay at home and work.”

Early this week, before her centers closed, Warthen said attendance was down to about a quarter of the typical number of children at her centers. Warthen’s staff scoured stores around Durham to buy enough food and milk to feed the children. They’d cleaned and sanitized throughout the centers more, as a safety measure. They also implemented policies so child care workers met parents at the door to keep them from coming inside to prevent the possibility of spreading COVID-19 any further by parents who were unknowingly exposed.

But DHHS sent notice that any child care center indicating centers staying open needed to consider taking in the children of emergency workers. The directive at that time lacked additional guidance on who would pay for that and was not explicit in stating whether centers could just stick to serving their existing families. That forced Warthen’s hand.

“It was the straw that broke the camel’s back,” Warthen said. “It was too much.”

Call for more help for day care centers 

A group of child care and children’s advocacy groups — The N.C. Early Education Coalition, N.C. Child and North Carolina Association for the Education of Young Children — called this week on Cohen and Gov. Roy Cooper to shut down all child care centers immediately in light of the growing public health crisis. Many of the workers are low-income themselves, unable to afford health care insurance, and work in a situation where social distancing is impossible when caring for infants and toddlers.

The state could then reopen centers willing to take on the children of health care and other front-line workers with emergency dollars.

The groups also advocated for financial support for child care centers, worried that as many as one-third in North Carolina might have difficulty reopening once the dangers of COVID-19 subside.

On Wednesday, Cooper said DHHS was trying to figure out solutions, but it wasn’t clear just what those would be.

“Clearly it is important for us to have child care for our front-line responders and we want to do that in the best way possible,” he said.

Jumping in to help 

In some places, community groups have jumped in to help front-line workers find child care. The YMCA of Western North Carolina is opening many of its sites in Asheville and the surrounding area to care for  babies and other children who can be as old as 12. The cost is free up to the end of March, but then will go up to $40 a day unless some type of federal, state or foundation dollars materialize to cover the cost.

Susan Jimison, a registered nurse with Hospice of the Carolina Foothills who does home visits, has been sending her 8-year-old Waylon to the McDowell County YMCA since school let out.

“I was really panicking about what I was going to do with him,” said Jimison, who also is a single mother. “I’m a hospice nurse and I have to get out to see my patients.”

And at the University of North Carolina at Chapel Hill, home to a major academic hospital system, medical students created spreadsheets to connect medical students with hospital staff such as nurses needing help with child care, watching pets, and picking up groceries, said Daniel Liauw, a fourth-year medical student who led the effort.

“We’re happy to help in any way we can,” Liauw said. “We all committed to serve our community.”

Also at UNC, surveys were sent out this week to hospital staff at the Chapel Hill locations and at UNC Rex Hospital in Raleigh to assess their needs for child care of all staff, including nurses and janitorial staff, said Hannah Prentice-Dunn, a project manager with UNC Lineberger Comprehensive Cancer Center who is helping the hospital system figure out child care options. A working group is hoping by the end of the week to identify the best ways to match staff with child care, and possibly leveraging some hospital foundation money to help pay for care as hospitals respond to COVID-19’s effects, she said.

Meanwhile, in Henderson County, the public-school system has opened up temporary child care centers to support health care workers.

The county school system normally provides before and after-school care for students and is using those workers to care for the school-aged children of health care and other essential workers at sites at 11 elementary schools, said Molly McGowan Gorsuch, a spokeswoman for the school system.

That includes caring for the children of workers at Pardee UNC Health Care, a community hospital in Hendersonville.

“Our intent is to offer this during the extent of our closure,” McGowan Gorsuch said. “But we’ll have to take things as they come, like everybody is doing.”