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Enfield Day Care Tragedies Prompt an Examination of Rules

During his 26 years as an Enfield police officer, Chief Richard Crate has seen children fall victim to homicide, to drowning, to sudden infant death syndrome.

But not until recently has he seen children die in a day care setting.

Last Monday, 4-year-old Willa Clark died after her jacket caught on a lean-to at an unlicensed Enfield day care, cutting off her airway. And last September, an 81/2-month-old boy died of unknown causes two days after falling unconscious at another unlicensed Enfield day care, Crate said.

Crate wants to know what can be done to prevent incidents such as these — “a tragic accident,” as he called Monday’s incident.

“This type of thing is out of the ordinary,” Crate said. But having two incidents in the past six months, both of which involved home day cares that state officials said should have been licensed, but weren’t, has prompted him to act. Crate said he plans to meet with the county attorney’s office and the state Child Care Licensing Unit this week to talk about child care.

“Obviously, the main topic is, what are some of the things we can do?” Crate said Friday.

The answer might be “not much,” at least not without a change in state law.

Child care regulators in New Hampshire and Vermont said they have virtually no authority over home day care providers that are legally exempt from regulations. The burden of determining whether a day care situation is safe, whether it’s regulated or not, falls on parents.

Under state law in New Hampshire and Vermont, home day care providers can remain legally exempt from state licensing if they meet certain criteria.

Vermont allows providers to remain exempt if they care for children from no more than two families, in addition to their own children. In New Hampshire, a day care is exempt if all the children in the home are related to the provider (for example, nieces and nephews in addition to a provider’s own children) or if there are no more than three children not related to the provider in addition to the provider’s own biological or adopted children.

Both of the day care providers involved in the Enfield incidents were operating outside state guidelines.

Mary Ellen Burritt, who had previously run a licensed day care at her home several years ago, was caring for Willa Clark and four other children, none of them related to her, state officials said. After Monday’s incident, she was issued a “cease operating” letter giving her 24 hours to comply with state law.

The September incident resulted in the death of Kolton Brigham Gunn. His parents declined to comment through a relative on Friday.

The boy was found unresponsive at his day care a little after 4 p.m., on Sept. 24, Crate said. He died two days later at Dartmouth-Hitchcock Medical Center, according to his obituary.

Crate declined to name the day care provider. Melissa Clement, chief of the state Child Care Licensing Unit, said the provider was issued a cease operating letter, which is generally used when a provider is caring for more children than legally exempt status allows .

The cause of death was never determined, and no charges were ever filed, Crate said.

Little Oversight

The incidents expose a blind spot that exists in both New Hampshire and Vermont: So long as legally exempt providers don’t exceed the thresholds set by state law, they need not even contact state regulators to open up shop.

That means child care regulators have no oversight of exempt child care providers except when they learn that a provider might be violating the conditions of exemption.

In 2013, New Hampshire’s Child Care Licensing Unit investigated 37 complaints against exempt day care facilities, Clement said. Of those, 19 resulted in the state issuing cease operating letters. Often, a complaint doesn’t contain sufficient information, such as the correct address, for the unit’s inspectors to act on.

“If it’s unlicensed, we can’t look into anything other than the number of children in care,” Clement said. Local police and health officers can investigate allegations of unsafe conditions, but such investigations are rare, she said.

Home day care providers can choose to become licensed, and there are benefits to doing so. For example, a day care that receives subsidy payments for children from low-income families will receive a higher rate if it’s licensed, Clement said.

But licensing also limits the number of children a provider can care for. In both New Hampshire and Vermont, the limit is six children.

“It’s not always a great incentive, numbers-wise, to get licensed,” said Chris Pressey-Murray, coordinator of the Dartmouth Child Care Project, which advises families and providers in the Upper Valley from an office in Hanover.

In Vermont, regulators have contact with legally exempt providers only if the providers receive state-federal subsidy payments, said Reeva Murphy, deputy commissioner for child development in Vermont’s Department of Children and Families. Even if there’s a complaint against an exempt home day care, state inspectors need a police officer to help with enforcement, Murphy said. “If children are in danger, our law enforcement guys step right up,” she said.

But a facility that’s merely providing borderline care, “that is a lot harder to deal with,” Murphy said.

An Important Role

The shortage of affordable licensed day care, whether home-based or in dedicated child care centers, means the exempt day care providers play an important role, particularly for lower income families, Pressey-Murray said.

Parents get some peace of mind from choosing a licensed center, since they are inspected by the state. Violations of health and safety regulations are posted on state websites and licensed day care providers are required to post notices of violations and corrective action on their premises.

In Enfield last week, Dunkin’ Donuts server Heidi Hossler said her youngest child, now 10, began attending day care at the age of 6 weeks. She found a licensed home care provider through a list provided by Women, Infants and Children, or WIC. Working from that list, she interviewed providers, paying particular attention to the ratio of children to adults, she said.

“You never know,” she said. “Cherish every moment.”

Brent Marinello, a Woodstock resident whose daughter lives in Enfield with his ex-wife and goes to Enfield Village School, said Willa Clark’s death concerned him, partly because the day care was unregulated.

“Politically, I’m not a huge fan of regulation,” Marinello said Friday. But “if we’re going to leave these without regulations, there needs to be accountability” when problems arise.

Given the lack of oversight of exempt programs, it isn’t always clear that they are worse than licensed ones. A Valley News examination of licensed day care center programs in April 2006 found that 20 percent of them had had violations in the past year.

(The 2006 story cited Burritt, who at the time ran Lothlorien Day Care, a licensed program, at her home. Regulators cited her program for having tap water that ran too hot for young children, a violation she corrected, the story said.)

“The majority of programs do have violations,” Clement said. “How the program chooses to respond to it will say a lot about their commitment to keeping children safe.”

A Big Black Market

Pressey-Murray noted that there are quality programs that are licensed and quality programs that are exempt. An informed parent is the best judge, she said.

“We encourage parents to know what the rules and regulations are,” Pressey-Murray said. They should also ask probing questions of any provider, licensed or exempt.

“Go and visit, check the physical environment,” she said. Talk to the provider about her experience, about what the typical day at the program is like and about how such activities as play, meals and naps are handled. Ask for references.

Murphy said her agency steers parents toward day care providers that have made the effort to register with the state. It’s a quality control measure.

But in the Upper Valley, there isn’t enough affordable, licensed day care to go around, Pressey-Murray said. Where a day care center might cost $350 a week in Hanover, $290 a week in Lebanon and $196 a week in Hartford, a week at a home-based day care can bottom out at $100, Pressey-Murray said. Both states offer subsidies for eligible families and some centers have a sliding fee scale, but the number of spaces is limited.

In that landscape, the legally exempt providers proliferate.

“I can’t really even guess at the number of exempt providers,” said Pressey-Murray.

“It’s a big market. It’s a big black market,” Murphy said.

Federal regulators are considering changes to how states scrutinize day care providers, Murphy said. Under the proposal, if someone is caring for a child who isn’t a relative, the state should visit.

“Our hope is that over the next two years we can bring those people into the regulated system,” Murphy said. States will have to develop new regulatory plans by October 2015, she said.

Results are just starting to emerge from a national survey of early childhood education, the first such study in 20 years, Murphy said. One of the early findings is that around 90 percent of home-based providers are unregulated.

“We have nowhere near the amount of (regulated) child care we need for the children,” Murphy said.

For Crate, the Enfield police chief, the big picture is in the background. He just doesn’t want to see another tragic accident at a day care in his town.

“That’s the question that we’re going to be asking when we all get together,” he said of his planned meeting with County Attorney Lara Saffo and state child care regulators. “What can we do? Is there anything we can do?”

“At the end of the day,” he added, “there may not be anything we can do but keep a closer eye on our kids.”

Valley News staff writer Nora Doyle-Burr contributed to this report. Alex Hanson can be reached at ahanson@vnews.com or 603-727-3219.