Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
TECHNICAL ASSISTANCE 
FOR 
QUALITY CHILD CARE: 
COMMUNITY PERSPECTIVES 
JUNE GIBBS BROWN 
Inspector General 
JUNE 1999 
0EI-07-97-00421  OFFICE OF INSPECTOR GENERAL 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as 
amended by Public Law 100-504, is to protect the integrity of the Department of Health and 
Human Services programs as well as the health and welfare of beneficiaries served by them.  This 
statutory mission is carried out through a nationwide program of audits, investigations, 
inspections, sanctions, and fraud alerts.  The Inspector General informs the Secretary of program 
and management problems and recommends legislative, regulatory, and operational approaches to 
correct them. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 
Inspector General.  It conducts short-term management and program evaluations (called 
inspections) that focus on issues of concern to the Department, the Congress, and the public.  The 
inspection reports provide findings and recommendations on the efficiency, vulnerability, and 
effectiveness of departmental programs. 
OEI's Region VII, Kansas City office prepared this report under the direction of James H. Wolf, 
Regional Inspector General.  Principal OEI staff included: 
REGION  HEADQUARTERS 
Deborah Walden, Project Leader  Linda Hall, Program Specialist

Tricia Fields, Program Analyst  Ann OConnor, Program Specialist

Ray Balandron, Program Analyst  Barbara Tedesco, Technical Support Staff

Perry Seaton, Program Analyst

To obtain copies of this report, please call the Kansas City Regional Office at (816) 426-3697. 
Reports are also available on the World Wide Web at our home page address: 
http://www.dhhs.gov/progorg/oei  E X E C U T I V E  S U M M A R Y

PURPOSE 
To determine the perceptions of community child care leaders regarding technical assistance 
provided under contract with the Administration for Children and Families (ACF), Child Care 
Bureau. 
BACKGROUND 
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 repealed a number 
of child care programs and created a single, integrated Child Care and Development Block Grant 
for low-income families.  Program goals are to ensure accessibility and affordability of quality 
child care for working families by promoting parental choice, encouraging States to provide 
consumer education to parents, and helping States implement health, safety, licensing, and 
registration standards.  The program is currently funded for a total of $20.9 billion for Fiscal 
Years 1996-2002. 
The ACF contracts with outside entities to provide technical assistance funded through this Grant. 
This technical assistance includes the coordination and support of regional and national 
conferences,  national workgroups, leadership forums, audio conference calls, and creation of the 
National Child Care Information Center.  In 1997, ACF further expanded its technical assistance 
capabilities by creating the Child Care Technical Assistance Network. 
While ACF provides technical assistance only to States, Territories, and Tribes, child care at the 
community level is ultimately affected.  To determine perceptions at this level, we surveyed 
100 community child care leaders regarding their sense of the technical assistance provided and 
the extent to which it meets their needs.  We asked them about the format and content of 
technical assistance, and to identify critical issues facing the child care community. 
FINDINGS 
Overall, community child care leaders are satisfied with the technical assistance 
Over 90 of the 100 participants surveyed are satisfied that the technical assistance they received 
addressed their concerns and was provided when they needed it.  They also view the technical 
assistance events as valuable opportunities to network, collaborate, and learn what other States 
are doing.  Their suggestions for improving technical assistance include updating invitation 
mailing lists and providing invitees with more advance notice of upcoming events. 
They prefer regional meetings and conferences 
Seventy-five participants express a preference for regional meetings and conferences because they 
are more narrowly focused and provide local or regional information which is often the key to 
improving the quality of child care.  Other technical assistance formats they find beneficial are the 
Internet, large national conferences, mailings, targeted technical assistance, audio conference 
calls, focus group events, and national workgroup meetings and forums. 
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i  The National Child Care Information Center is a valuable technical assistance tool 
Almost two-thirds (63) of the participants are familiar with the National Child Care Information 
Center and 59 are aware of the Child Care Bulletin published by the Center.  They report that 
information provided by the Center is helpful and promptly provided upon request.  Nearly 
one-fourth (24) have also accessed the Centers homepage on the World Wide Web and find it 
beneficial. 
Participants identify subsidy payments, infant/toddler care, school-age child care, welfare 
reform, Head Start/child care collaboration, and inclusion of children with disabilities as the 
most critical issues facing child care 
Forty-four participants identify subsidy payment rates and/or sliding fee scales as a critical child 
care issue.  It is followed by infant/toddler care, school-age care, welfare reform, Head Start/child 
care collaboration, and inclusion of children with disabilities as other critical issues. 
OPPORTUNITIES FOR IMPROVEMENT 
Clearly, community child care leaders think highly of the technical assistance they are receiving. 
However, based on our analysis of their responses, we identified a few areas where improvements 
could make this program better.  We therefore suggest that ACF work with technical assistance 
contractors and regional office staff to 
-- Improve advance notice and information about upcoming events. 
-- Focus technical assistance on issues community child care leaders consider 
critical. 
-- Continue to support the National Child Care Information Center, but enhance the 
technical assistance provided through its website. 
AGENCY COMMENTS 
The ACF concurs with our suggested opportunities for improvement and describes recent changes 
in their technical assistance initiatives.  Their comments are included in Appendix A. 
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ii  T A B L E  O F  C O N T E N T S

PAGE 
EXECUTIVE SUMMARY

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FINDINGS

Overall satisfaction  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Preference for regional meetings and conferences  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Value of the National Child Care Information Center  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

  Information Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

  Website  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

  Child Care Bulletin  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Specific technical assistance needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

OPPORTUNITIES FOR IMPROVEMENT  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

AGENCY COMMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  A-1
 I N T R O D U C T I O N

PURPOSE 
To determine the perceptions of community child care leaders regarding technical assistance 
provided under contract with the Administration for Children and Families (ACF), Child Care 
Bureau. 
BACKGROUND 
Legislation 
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 repealed the 
Title IV-A child care programs (Aid to Families with Dependent Children/Job Opportunities and 
Basic Skills Child Care, Transitional Child Care, and At-Risk Care) and created a single, 
integrated Child Care and Development Block Grant (CCDBG), also called the Child Care 
Development Fund, for low-income families.  Legislation requires the ACF to provide States, 
Territories, and Tribes with technical assistance focused on the achievement of Child Care and 
Development Block Grant program goals.  Program goals are to ensure accessibility and 
affordability of quality child care for working families by promoting parental choice, encouraging 
States to provide consumer education to parents, and helping States implement health, safety, 
licensing, and registration standards. 
Funding 
Consolidation of all child care programs into the CCDBG dramatically increased the amount of 
technical assistance funds available, from $2.3 million in FY95 and $2.6 million in FY96 to $6.6 
million in FY97 and over $7 million in FY98.  With the Presidents new child care initiative 
announced in January 1998, the ACF estimates that funding available for technical assistance 
could increase even more.  The entire CCDBG program is currently funded for a total of $20.9 
billion for Fiscal Years 1996-2002. 
Technical Assistance Contracts 
The ACF initially awarded a contract for technical assistance to J&E Associates for Fiscal Years 
1993 and 1994.  The technical assistance provided through this contract focused on certificate 
payment programs mandated by newly enacted legislation.  This legislation required that States 
have a system capable of operating a certificate payment program in place by October 1, 1992  to 
allow parental choice in the selection of child care providers.  Under this contract, States and 
tribes were surveyed regarding their certificate program capabilities and technical assistance 
needs.  In addition, regional meetings and national child care conferences were conducted. 
Upon expiration of the contract with J&E Associates, a new 3-year contract was awarded to 
Trans-Management Systems Corporation (T-MSC) in cooperation with Collins Management 
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1  Consulting.  With reauthorization of the Child Care and Development Block Grant in 1996, this 
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2
 contract was extended for an additional year.  Technical assistance provided under contracts with 
these companies included convening, supporting, and/or administering 
  State, territorial, and tribal work groups, 
	 Annual conferences, such as National State Child Care Administrators Conferences, 
National American Indian and Alaska Native Child Care Conferences, and national 
leadership forums focused on specific issues related to child care, 
  regional child care conferences, and 
  the National Child Care Information Center. 
Contractor responsibilities also encompass a multitude of logistical support activities associated 
with convening and coordinating workgroups and conferences, such as securing adequate meeting 
facilities, hotel accommodations and presenters, compiling invitation and participant lists, 
designing agendas, and providing advance notice of upcoming events.  They also provide travel 
arrangements and reimbursement for conference presenters, and in some instances (i.e., National 
State Child Care Administrators Conference) for some conference attendees. 
The National Child Care Information Center complements, enhances, and promotes child care 
linkages and serves as a mechanism for supporting quality, comprehensive services for children 
and families.  To carry out their work, it provides question and answer services, an Internet and 
digital library, information resources collection and dissemination, and linkages to other websites 
and information sources.  Questions and requests for information received by the Center come 
from a variety of sources via telephone (1-800-616-2242), fax, e-mail, and contacts at meetings 
and conferences.  The Center also publishes a website located at http://nccic.org.  This website 
serves as a starting point for child care information about State and tribal program activities, 
funding resources, organizations, child care research, welfare reform, health and safety, promising 
practices, leadership forums, conference calendars, and other child care resources.  The 
Information Center activities include 
	 dissemination of child care information in response to requests from States, Territories and 
Tribes, policymakers, parents, programs, organizations, child care providers, and the public. 
  maintenance of the website. 
	 serving as the adjunct for the Educational Resources Information Center clearinghouse for 
child care via the National Child Care Information Center website. 
  publication of the Child Care Bulletin newsletter. 
In 1997, the ACF redesigned their technical assistance approach to address emerging child care 
issues and technical assistance needs.  Through this redesign the ACF created a Child Care 
Technical Assistance Network which was in the early stages of development at the time we 
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3  conducted this study and not evaluated.  This new Network is comprised of seven independent 
projects, each awarded to an individual contractor.  These projects and contract awardees are the 
	 National Child Care Information Center 
(Collins Management Consulting, Inc.), 
	 Child Care Bureau Logistical Support Project 
(Trans-Management Systems Corporation), 
	 Healthy Child Care America Campaign 
(Inter-agency agreement between the ACF, Child Care Bureau, and the Maternal and 
Child Health Bureau, implemented through the American Academy of Pediatrics), 
	 Tribal Child Care Technical Assistance Center 
(Native American Management Services, Inc.), 
  Child Care Partnerships Project (The Finance Project), 
	 Child Care Inclusion for Children with Disabilities 
(University of Connecticut Health Center ), and 
	 Child Care Information Systems Technical Assistance Project 
(SRA International, Inc.). 
These projects will allow continuation of the National Child Care Information Center, the website, 
and the Child Care Bulletin.  They will also play a major role in continuing to address ongoing and 
emerging child care issues and technical assistance needs at both the national and State levels 
through national and regional conferences, forums, and audio conference calls. 
SCOPE AND METHODOLOGY 
While ACF provides technical assistance only to States, Territories, and Tribies, child care at the 
community level is ultimately affected.  As such, this inspection focuses on the perceptions of child 
care community leaders and individuals associated with improving and ensuring the quality of child 
care regarding contracted technical assistance provided by the ACF, Child Care Bureau, with block 
grant funds. 
In determining our sample of child care community leaders, we selected 100 individuals to 
participate in our study who had taken part in a technical assistance event sponsored with Child 
Care and Development Block Grant funds between May 1995 and December 1997.  The 
participants were selected at random from 38 lists of event participants provided to us by 
Trans-Management Systems Corporation, the contractor responsible for convening, supporting 
and administering technical assistance during this time.  Before selecting our sample, we excluded 
State child care administrators from the universe because we had surveyed them regarding their 
perceptions of technical assistance in a previous study.  As such, our sample provided us with 
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4  participants from 35 State agencies (i.e., State Departments of Human Services, Social Services, 
Education, Labor, etc.), and various other agencies and organizations which include Head Start 
agencies (13), non-profit agencies (11), local community organizations (5), local government 
agencies (5), universities (5), child care providers (5), child care resource and referral agencies (5), 
welfare affiliated organizations (3), other technical assistance providers (2), and other entities 
associated with an interest in quality child care. 
We conducted telephone surveys with sample participants to solicit information on each ones 
satisfaction with various aspects of the technical assistance contracts.  This included the event they 
attended, critical issues facing the child care community, their familiarity with the National Child 
Care Information Center, and the Child Care Bulletin. 
This is one of three inspections to focus on various entities perceptions of technical assistance 
provided by the ACF, Child Care Bureau.  In a previous report, Technical Assistance for Quality 
Child Care: State Administrators Perspectives, we address the perceptions of State child care 
administrators.  A future report will address the perceptions of ACF regional office staff. 
We conducted our review in accordance with the Quality Standards for Inspections issued by the 
Presidents Council on Integrity and Efficiency. 
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5  F I N D I N G S

Overall, community child care leaders are satisfied with the technical assistance 
We asked community child care leaders who participated in the survey to rate their overall 
satisfaction with the technical assistance event attended, and whether or not the information 
provided at those events addresses their concerns and was received when they needed it.  In 
response, over 90 of the 100 participants (91 and 92 respectively) are satisfied that the information 
addresses their concerns and is provided when needed.  Many child care leaders indicate that the 
technical assistance events also provide them with valuable opportunities to network, collaborate, 
brainstorm and learn about what other States are doing. 
Some of their suggestions for improving technical assistance include updating invitation mailing 
lists, getting the right people included in technical assistance events, and providing invitees with 
more advance notice of upcoming events.  They also suggest that more advance information about 
the focus of upcoming events would allow them to better prepare and participate in event 
discussions. 
They prefer regional meetings and conferences 
When asked to identify the formats they find most beneficial, 75 participants indicate they find 
regional meetings one of the most beneficial technical assistance formats.  Of those, 60 indicate 
they prefer small regional meetings and 47 prefer large regional conferences.  Thirty-two indicate a 
preference for regional events in general, both large and small.  They comment that smaller 
meetings are better focused and, while learning about national perspectives and trends is important, 
local or regional information is often the key to improving the quality of child care.  Other formats 
in order of preference are information provided via the Internet (33), large national conferences 
(27), mailings (26), targeted technical assistance provided upon request (23), audio conference 
calls (18), focus group events (18), national workgroup meetings (13), and national forums (9). 
The National Child Care Information Center is a valuable technical assistance tool 
The Information Center 
Sixty-three of the participants surveyed are familiar with the National Child Care Information 
Center.  Of those, 33 indicate they have contacted the Center for information and 30 indicate that 
the Center is able to provide requested information, and that information is provided in a timely 
manner and is helpful. 
Most participants became aware of the Center through information provided at technical assistance 
events and conferences.  They indicate most of their requests to the Center are for information 
about what other States are doing (7) and various statistical information (5), which is consistent 
with the types of requests the Center receives overall. 
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6  The Website 
Most participants (80) have access to the Internet, and 24 indicate they have accessed the Centers 
homepage on the World Wide Web.  The Center reports over 358,000 individuals visited the 
website between February 1998 and January 1999, a 62 percent increase over the previous year, 
and that each accessed an average of 6 internal pages with each visit. 
Survey participants indicate the website information they find most useful relates to what other 
States are doing and statistical data, the same types of information they most frequently request 
from the Center itself.  Participants also note that the Centers website is a good link to other sites, 
and that they refer others to the website.  The 24 community child care leaders that have accessed 
the website report the frequency of their website access as weekly (1), monthly (7), occasional 
(12), seldom (3), and no response (1).  Their suggestions for improving the website are to include 
more news on program policy and operation from HHS and university extension information. 
The Child Care Bulletin 
Fifty-nine of the participants are familiar with the Child Care Bulletin, a newsletter published by 
the National Child Care Information Center.  Through the Center, the ACF uses this bulletin as a 
tool to disseminate information resources to approximately 3,000 subscribers.  It includes 
information on Federal requirements and program changes, innovative approaches to quality child 
care, and examples of model programs. 
Fifty-one of the participants surveyed receive copies of the bulletin on a regular basis, 39 of which 
indicate they are on the mailing list.  Other participants receive copies of the bulletin from other 
sources (9) or via the Internet (3).  All 51 comment they find the issues addressed in the bulletin to 
be timely and of interest to them in meeting their needs.  They indicate the bulletin is a good 
general reference for child care issues (7), is a valuable tool for presenting national perspectives 
and trends (6), and a good format for providing legislative activity information. 
Participants identify subsidy payments, infant/toddler care, school-age child care, welfare 
reform, Head Start/child care collaboration, and inclusion of children with disabilities as the 
most critical issues facing child care 
We presented survey participants with a list of technical assistance issue areas and asked them to 
identify the three most critical.  From that list 44 participants identified subsidy payments/sliding 
fee scales as a critical child care issue.  It is followed by infant/toddler care (36), school-age child 
care (31), welfare reform (28), Head Start/child care collaboration (27), and inclusion of children 
with disabilities (26) as other child care issues they consider critical. 
We also asked them to further refine their selection by naming one of the three selected issues as 
most critical. Again, subsidy payments/sliding fee scales was selected as the most critical issue 
(16).  It is followed by welfare reform (11), infant/toddler care (9), and Head Start/child care 
collaboration (8).  Survey participants comment that adequate subsidy payments are important to 
attract good child care providers, which in turn will affect the quality of child care being provided. 
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7  They also note that quality child care must be available for welfare reform to be successful.  Other 
issues participants identified as critical, but not included in our list, are staffing and wages, child 
care during non-traditional hours, transportation, child care in rural areas, and blending child care 
funding streams.  A list of critical issues most noted by child care community leaders is outlined 
below. 
Critical Child Care Issues 
Number of Survey Participants 
Who Selected Issue As: 
Most 
Issue  Critical  Critical 
Subsidy Payments and Sliding Fee Scales
 44  16 
Infant/Toddler Child Care
 36  9 
School-Age Child Care
 31  7 
Welfare Reform
 28  11 
Head Start/Child Care Collaboration
 27  8 
Inclusion of Children with Disabilities
 26  7 
Provider Training Programs
 17  5 
Collaboration/Coordination with Other Agencies
 13  4 
Provider Accreditation
 9  0 
Health and Safety
 7  2 
Child Care Resource and Referral
 7  3 
Family Centered Child Care
 6  2 
Sharing Information with Other States
 5  0 
Number of Respondents = 100

In addition, we asked participants to identify issues that may become critical in the future.  In 
response they indicate certain broad issues such as salaries, welfare reform, provider accreditation, 
child care for working poor families, infant/toddler child care, and school-age child care as 
projected critical issues for the future. 
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8  O P P O R T U N I T I E S  F O R  I M P R O V E M E N T

Clearly, community child care leaders think highly of the technical assistance they are receiving. 
However, based on our analysis of their responses, we identified a few areas where improvements 
could make this program better.  We therefore suggest that ACF work with technical assistance 
contractors and regional office staff in the following three areas. 
Improve advance notice and information about upcoming events 
!  Periodically update invitation lists.

!  Furnish those invited with adequate advance notice of upcoming events.

!  Provide invitees with specific information about the focus of upcoming events.

Focus technical assistance events on issues community child care leaders consider critical 
!  Subsidy payment rates and sliding fee scales

!  School-age child care

!  Welfare reform

!  Head Start/child care collaboration

!  Inclusion of children with disabilities

!  Infant/Toddler child care

Continue to support the National Child Care Information Center, but enhance the technical 
assistance provided through its website 
!	 Provide technical assistance participants with more information about the website and its 
use. 
!	 Make available more information about State practices and policies, successful program 
models, and upcoming technical assistance events through the website. 
AGENCY COMMENTS 
The ACF concurs with our suggested opportunities for improvement and describes recent changes 
in their technical assistance initiatives.  Their comments are included in Appendix A. 
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9  A P P E N D I X  A

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A - 1
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A - 2
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A - 3
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A - 4
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A - 5
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A - 6