DOCUMENT RESUME

ED 381 268 PS 023 177

TITLE Child Care Management Information Systems: ApplyingTechnology To Improve Child Care.

INSTITUTION Macro International, Inc., Silver Spring, MD.SPONS AGENCY Administration on Children, Youth, and Families

(DHHS/ACF), Washington, DC. Children's Bureau.PUB DATE Dec 94CONTRACT 105-92-1616NOTE 23p.

PUB TYPE Reports DescriptiVe (141)

EDRS PRICE MFO1 /PCO1 Plus Postage.DESCRIPTORS *Day Care; Early Childhood Education; Government

Role; Long Range Planning; *Management InformationSystems; *Planning; *School Administration; *StateRegulation; *Systems Approach

IDENTIFIERS Arizona; Arkansas; *Child Care and Development BlockGrants; Maryland; New Jersey; Oregon

ABSTRACTDuring the summer of 1993, site-visit teams visited

Arkansas, Arizona, Maryland, New Jersey, and Oregon to interview theChild Care Development Block Grant (CCDBG) lead agency staff abouteach state's child care management information system (MIS). Thestate information work group and experts recommended states withinnovative, unique, and successful approaches to managing variousaspects of child care programs. In each state, the site-visit teamspent 2 to 3 days interviewing child care administrators, child careresource and referral (CCR&R) staff, programmers, and other MISusers. During these visits, the site-visit team obtained informationon the state child care programs' background and evolution. Criticalissues and lessons learned for other states include: (1) take time inthe planning stages; (2) when implementing and developing a MIS,ensure close communication between policy and systems developmentstaff; (3) involve the user at all points of development; (4) ensurethat MIS staff understand existing child care policies andprocedures; (5) obtain commitment from high-level program and MISstaff prior to developing the MIS; (6) resolve as many policydifferences as possible before developing the automated system; (7)

desigi the system to meet specific needs of the state, clients, andproviders; (8) design the system to be flexible; (9) expect delays inthe time required to develop an operational system; and (10) plan forcomprehensive training. (Two appendices provide an overview ofstates' MIS design and architecture and a summary of states'organiza ional structure of child care and MIS.) (DR)

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Reproductions supplied by EDRS are the best that can be madefrom the original document.

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U S. DEPARTMENT OF EDUCATIONOffice of Educational Researcn ens Improvement

EDUCATIONAL RESOURCES INFORMATIONCENTER (ERIC)

\ilfc This document has been reproduced asreceived from the person or organizationoriginating it.

Minor changes have been made toimprove reproduction quality.

Points of view or opinions stated in thisdocument do not necessarily representofficial OERI position or policy

Child Care ManagementInformation Systems:

Applying Technology toimprove Child Care

Prepared for:

Child Care Division

Administration for Children and FamiliesDepartment of Health and Human Services

Prepared by:

Macro International Inc.Child Care and Development Block Grant

Technical Assistance ContractContract No. 105-92-1616

December 1994

Preface

States and Programs Visited

During the summer of 1993, site-visit teams visited Arkansas, Arizona. Maryland, New Jersey, andOregon to interview the Child Care and Development Block Grant (CCDBG) lead agency staffabout each State's child care management information system (MIS). An information workgroupof 10 State child care administrators helped select the States to be visited, with additionalinformation being provided by experts in child care management information systems. The Stateworkgroup and experts reviewed information on State programs and recommended States withinnovative, unique, and successful approaches to managing various aspects of child care programs.In each State, the site-visit team spent two to three days interviewing child care administrators,child care resource and referral (CCR&R) staff programmers, and other MIS users. During thesevisits, the site-visit team obtained information on the State child care program's background andevolution, as well as specific information about promising practices to be highlighted in thisarticle.

Child Care Management InformationSystems: Applying Technology toImprove Child Care

Introduction

Managing child care services has becomeincreasingly complex for State child careadministrators: the demand for child care hasgrown substantially, new funding sources havebecome available, and an approach toproviding "seamless" services has emerged.Administrators are beginning to develop anduse automated management informationsystems to help them manage child careservices.

The number of parents entering the workforce in the last decade created heavy pressureon States to respond to the lack of child caresupply, the instability of many child carearrangements, and the high percentage offamily income that many parents pay for childcare. Many States had little or no"infrastructure" to respond to these increaseddemands. States' traditional child careoperations were not designed to handle theevolving intricacies, scope, and linkagesamong child care funding streams andbetween child care and other social serviceand public assistance programs that havebecome necessary today. While States tried tocope with these complex responsibilities,many also experienced reductions in staff dueto State recessions.

Several new Federal funding sources havehelped to meet this increased demand forchild care by providing resources to expandand improve child care services. The majornew sources of funds are the Child Care andDevelopment Block Grant (CCDBG), the TitleIV-A JOBS/Supportive Services Child Care,Transitional Child Care (TCC) and the At-RiskChild Care Program (ARCC). With the addition

of these new sources of funds, Stateadministrators began facing challenges ofblending or "pooling" these monies frommultiple funding streams to benefit childrenand families while at the same timeresponding to the separate rules andreporting requirements associated with eachof these funding sources. Attempts tointegrate these funding sources have resultedin an approach now referred to as seamlessservice delivery.

In addition to moving toward seamlessservices with an expanded number of fundingstreams, the CCDBG and ARCC programs alsorequired States to develop "certificate"payment systems. Although certificateprograms expanded family choices byallowing a wider varier of providers toreceive funding (and taus the volume of childcare providers increased dramatically), theyoften required major changes in providereligibility requirements, payment procedures,processing capacities, reporting categories,rate structures and monitoring functions.

To cope with these many and complexchanges, administrators found that theyneeded to design or adapt their child careservices to move them toward coherent,related, equitable and continuous proceduresand policies that could be readily understoodby families, child care providers, and variousState agency staff. Many State administratorsare interested in managing their complexresources more effectively, turning tosophisticated computer systems to improvethe management of their child careinformation and operations. A properlyplanned automated Management InformationSystem will assist child care administrators in

developing seamless services by automatingmany functions associated with thesecommon policies and procedures.

It is important to remember that whenmost States began child care services withTitle V< or State funding (1970's), theydeveloped manual eligibility and paymentsystems using computer technology whenthey could locate the resources to pay for anddesign them. Some advanced theircomputerized systems in the 1980's with thefocus on the development of the Federallysupported FAMIS system (Family AssistanceManagement Information System) thatallowed for the inclusion of child care as asupport for families receiving welfare.However it was 1991, when Federal resourcesfor automation for child care specificallybecame available through title 1V-A, that Statesbegan to move forward with automation.

This article summarizes five States'experiences with developing and operatingcomputerized child care MIS. Each of the fiveStates employed innovative strategies in thesystem planning and development stages andhas installed creative system features. Thecombined experiences of these Statesillustrate common successful strategies as wellas problems, pitfalls, and barriers to thesuccessful development and implementationof an automated child care MIS.

The article is divided into the followingsections:

Benefits of an automated child caresystem;

Planning a system;

System development andimplementation;

System functions;

System management and training; and

Critical issues and lessons learned.

Appendix A provides a table with an overviewof each State's system. Appendix B describesthe organizational setting for each State'schild care program and MIS.

Benefits of a Child Care ManagementInformation System

Managing and integrating the various childcare funding streams is difficult for child careadministrators to accomplish with a manualinformation system. The five States in thisstudy concluded that they could not havecoped without automation. Several principalneeds acted as catalysts for these States todevelop an automated child care MIS:

The need to enhance the servicesystem's ability to provide families andchildren with continuous services byorganizing the administrative functionsassociated with various fundingsources to benefit families (to make itmore seamless to families);

The need to assist families in obtainingchild care in the simplest, quickest,and least obtrusive manner;

The need for prompt payments tochild care providers;

The need for quick and accuratedeterminations of client eligibility; and

The need to make sense of theinformation being processed so thatplanning, analysis, and reporting couldoccur in a timely manner and with ahigh degree of accuracy.

The goal of a seamless child care system isto provide eligible families with continuousaccess to approved providers whilemaximizing families' choices of child caresettings, regardless of any changes in thesource of funding that supports a particularfamily. A child care MIS providesadministrators with invaluable tools for

matching funding sources that are beneficialto the State, providers, and families asefficiently as possible. Prompt paymentfeatures, fostered by a well designed MIS andlinked to a responsive State financial system,act as an incentive for providers who mightotherwise be reluctant to participate insubsidized child care. Automated eligibilitydetermination (and re-determination) is notonly quick and convenient for families, butalso ensures that funds are drawn down fromthe most appropriate source and are not overor underspent.

What Can an Effective MIS Accomplish?

The MIS should automate basic servicedelivery and business functions. This assistslocal caseworkers, parents, child careproviders, and State agency directors.

For parents, an MIS can reduce thetime it takes to enroll in variousprograms. It quickly processes theireligibility so that parents can find outalmost instantly for which programsthey are eligible. Also, an MIS canprovide information and referrallistings for parents.

For child care providers, an MISmakes payments to providers quickly,it reduces errors, speeds payments,and produces reports for child careproviders.

For child care intake workers (alsoknown as child care specialists,eligibility workers), an MIS can greatlyreduce data management work. Bybuilding in determination of eligibilityand funding stream priorities, the MIScan do the tedious "looking-up" oftables, schedules, policies, and fundingavailability In this way, States foundthat their MIS reduced the amount oftime caseworkers must spend onpaperwork allowing them more time

for an increased caseload and formanaging their work.

For program administrators, an MIScan manage funding streams; provideorganized information on programresources and utilization; generatedetailed demographic data on childrenand families using child care; produceclaims and expenditure reportscorresponding to both State andFederal requirements; and detectduplicate payments, fraud, and otherfinancial problems.

Planning a System

An automated MIS is only as good as theplanning that goes into it. Before the MIS canbe designed, States must develop a clear anddetailed plan for the system. The planningshould include a needs assessment, feasibilitystudy, a review of alternatives and an analysisof the required hardware and software. It ishelpful for the various agencies related tochild care in a State to include in the needsassessment the various requirements offunding sources so that the MIS can be usedto integrate them and produce reports. Then,they must develop the policies andprocedures associated with the eligibility andpayment system, including the changes thatmay be connected with the certificateprogram. Planning requires close cooperationbetween child care agency staff and the MISdevelopers. This section contains suggestionsmade and methods used by the five States intheir MIS planning processes.

Using Systems Developed in Other States

Ideally, a State interested in developing a childcare MIS would learn from another State thathas already gone through the process. TheStates in this study had discussions with otherStates about how they designed their systems.Arizona. Arkansas, and Maryland actively

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looked at the systems developed in otherStates. Arizona was impressed with Utah'smodular system, and ultimately adopted thesame general design. Arkansas systemdevelopers learned about Tennessee's touch-tone billing system during a site visit, andultimately adopted the concept. Marylandstaff; on the other hand, looked at severalsystems but did not find any that offered thetype of comprehensive system they wanted.Ultimately, the five States found that, whileother States offered them ideas, their uniquesituations required systems tailored to theirindividual needs.

Interagency Oversight Committees

In each State, the functions necessary forplanning and implementing an MIS aredivided among different agencies. Typicalparticipants in MIS operations includecomputer resource divisions, the Statetreasurer or comptroller, social servicesagencies, and county and regional agencies.All of these positions need to be included inMIS development.

Four of the five States used an interagencyoversight committee to avoid turf issues andensure that all agencies with a potentialinterest in the MIS would participate. Thesecommittees discussed the outcomes desired,set policy, developed system specifications andrequirements, and directed systrmdevelopment. The committees varied widelyin size from fewer than 10 members to morethan 100. Larger committees formedsubcommittees or task forces to addressspecific problems or issues. Several Statesreported that the interagency committee wascritical to MIS development, but that theprocess was also intense and often fraughtwith frustration.

Arkansas's oversight committee's operatingphilosophy required that all committeemembers be informed of and approve anychanges to the system. This philosophyhelped to eliminate problems generated bythe differing needs of various divisions andunits. The operating philosophy became

necessary because of the gap in understandingbetween computer specialists on thecommittee and the program servicesspecialists without much computerknowledge. Committee members felt this gapwas contributing to major problems:seemingly minor changes in the computersystem required a disproportionately largeeffort to implement. Arkansas and otherStates found that an operating philosophy ofvaluing close coordination among all keypeople was absolutely essential. The ability totranslate child care system needs intoinformation that is helpful. to computerspecialists and the ability to translate thetechnical information needed by thecomputer specialists to the child care staff iskey to the planning, development, andoperation of an MIS.

Arkansas Oversight Committee'sOperating Philosophy

"Individual divisions, units, or agencies cannotmake a change in any part of the system withoutinforming all committee members of the proposedchange(s) and obtaining approval from a majorityof the committee members."

Advisory and User Groups

A successful MIS must be accurate, accessible,and responsive to the people who will use it,such as local caseworkers. Users know whatdata must be gathered as well as the specialproblems and circumstances that do not fitstandard procedures. They also know theactual flow of their work day and can providea "reality-check" for programmers who mayonly have an abstract understanding of thejob. For this reason, the five States involvedpotential system users in every phase of thedesign and development of their MIS.

Several States assessed the staff activities oflocal child care offices in order to understandcaseworkers' jobs and the problems withthen-current procedures. Intrinsic to effective

system design is not only an understanding ofhow things work, but also an understandingof how they should work. Arkansas used agroup of child care providers to help plan itsMIS. New Jersey checked with each of itscounties to learn how they implemented Stateguidelines in their manual systems beforedeveloping the computer edits for the MIS. InMaryland, each local department of socialservices office was asked to complete dailytask sheets which were subsequentlyincorporated into the specifications for thesystem. Child care and informationmanagement staff also conducted a jointanalysis of the offices where the localcaseworkers would be using the system. Afterinstallation, State staff returned to the localoffices to orient local users to the system.

States found that, during actual systemdevelopment and programming, day-to-day

- contact between policy and programmer staffis best handled by just one or two people whoact as liaisons. The liaison staff, the"translators," were selected for their ability todescribe computer system functions inlanguage that both program and policy staffcan understand and to describe programfunctions in a way that programmers canunderstand.

The Link Between Planning for theCertificate System and the MIS

Close coordination among MIS staff, childcare agency staff and licensing staff is neededto smoothly incorporate the changes relatedto the operation of a certificate programwithin the overall child care MIS. The CCDBGlegislation requires that the State give parentsthe flexibility to choose from an expandedarray of child care providers. Certificates,defined as financial assistance to parents, arethe mechanism for expanding choice andincreasing the supply of child care thatreceives public funding. This law allowsFederal subsidies to go to previouslyunregulated (exempt) providers who meet theregistration requirements of the CCDBG andto relative caregivers.

In order to meet the dual objectives ofattracting new, unregulated chilci careproviders, and providing some degree ofconsumer protection, the provider eligibilityand payment system must be simple, stable,and quick. The core of any child care MIS isits ability to track payments to approvedproviders on behalf of families who meet theprograms' eligibility requirements. Althoughthe MIS functions as a funds management tool(usually linked to, and in combination with,the State financial system), the child care MIScan address broader information and policyneeds.

While States had different degrees ofcertificate payment systems in place before theFederal deadline of October 1, 1992, manyStates used the certificate payment system asan entree to making major changes in theirchild care MIS. Major issues typically includedthe following:

making and accounting for payments;

addressing administrative and casemanagement issues, especiallyestablishing fiscal controls;

exchanging data with other socialservice, licensing, welfare andeducation systems;

maintaining a list of providers; and

providing families with information onchoosing and locating child care.

Certain States noted that, as much as possible,policy and procedural issues regardingcertificate programs should be resolved beforedeveloping the MIS. The importance of childcare and computer specialist translators, orliaisons, is key. Without them, major changesmade in policies after the system wasdesigned necessitated expensive changes inthe MIS. Several States also recommendedthat program staff write a manual for thecomputer programmers responsible for

designing the MIS that describes how thechild care program operates.

System Development andImplementation

Strict attention to details is necessary at everystage of MIS development. States had severalrecommendations about how to achieve anoptimal system. These relate to the use ofadvisory and user groups, phased-in systemdevelopment, choosing database designs andthe use of contractors.

Phased-in System Development

Most of the States visited for this projectdeveloped their MIS in stages. They foundthat, by phasing in the system developmentactivities over time, they were able to providemore flexibility for staff to adjust to changes.Phasing also permitted central office staff tomake necessary linkages with other systems inan orderly manner. The development of eachState's MIS required different stages based onthe current state of automation of theirsystem, the need for interfaces with othersystems, and other factors such as schedulingand budgets. However, the following stageswere typical in the development of thesystems in several States:

Defining the system. The agencycompletes a needs assessment, does afeasibility study, and identifies itsautomation goals and objectives. Theagency defines which work processesneed to be automated, designates thepotential users, selects the types ofinformation needed to operate theprogram, and identifies othercomputer systems with which the MISinterfaces.

Conducting a requirements analysis.States typically study every aspect ofthe system. This includesidentification of the computer

hardware and software, lists of all datathat need to be entered into thesystem, relationships betweenmodules, the structure of computerreports, and other issues such as datasecurity, confidentiality, and trainingneeds. Linkages with other databasesneed to be determined, such as theState's Family Assistance MIS (FAMIS)and other financial systems.

Developing a functional design.Computer programmers and systemanalysts usually prepare detailed flowcharts showing how the program willstore and manipulate data, andprogrammers prepare descriptions ofwhat will actually appear on the user'scomputer screen. The design stagealso should show users what computerreports will look like and what datathey will include.

Testing and piloting the system. Asmodules (stages, components, tables)are completed, the developers shouldtest each to make certain that it works.Then a small group of users shouldpilot the system to ensure that the MISperforms adequately.

Installing and implementing thesystem. After testing to remove bugs,more hardware and software areinstalled, and users are trained in thesystem's use. The entire system can beinstalled at once or individual modulescan be installed in phases.

Maintaining the system. Training andsupport to both the child careprogram staff and the technicalsupport staff is key to the ongoingoperation of the MIS. Most systemsneed occasional fine-tuning as bugsmaterialize and better data entry andreporting methods are developed.Also regular communication is neededbetween the child care staff, computer

personnel, accounting and financesystems staff.

Modular System Design

Management information systems should bevery flexible. By initiating a modular design,changes can be made to one module withoutnecessitating changes to the entire system.System functions can be performed by a singlemodule or through the interplay of severalmodules. If the entire system must beestablished quickly, numerous programmerscan work concurrently on separate modules.A longer development period permits thephasing in and testing of each module, withnew modules being added as time and budgetpermit. The Arizona Social ServicesInformation and Statistical Tracking System(ASSISTS) illustrates the logic of a modularsystem developed sequentially (see box).

Arizona's ASSISTS: A Modular Approach

The five modules in ASSISTS are:

Client Pathway Module: maintains client data

and adds clients to the system

JOBS Module: provides an on-line interfacewith the JOBS database.

Provider Module: stores data on licensedcenters, certified homes, relative providers, and

child welfare service providers.

Payment Processing: generates paymentwarrants.

Alerts Subsystem: sends both computer and"hardcopy" notices when information changes

among the ASSISTS modules as well as the data

systems with which It interfaces.

Using Contractors to Design and Developthe MIS

Of the States reviewed, three decided codevelop the MIS in-house. and the other twoopted for computer contractors. The decisionto contract out depended upon the availabilityof agency or other State computer specialistscapable of designing a large-scale system.Arizona decided to do the project in-house, inspite of tight deadlines.

Two of the five States, Maryland and NewJersey, used outside contractors. Marylandstaff developed several explicit requirementsfor their contractor including an extensiveuser training guide, a software documentationmanual and customized programs.

Training

The five States provided both elementarytraining (basic introduction to computers,how to use the keyboard, etc.) and moresophisticated training on the MIS and systemfeatures to (such as report writing), to MISusers.

Maryland deliNvered training at eachimplementation phase. State-level child careand information management staff, who hadbeen trained directly by the contractor,instructed local-office staff. As each module ofthe system was implemented, local-office staffcame to the State center in Baltimore fortraining. Staff received a detailed systemsoperation manual and, upon returning totheir offices, went through additional self-training through an interactive computerprogram. Local-office staff referred anyquestions to the State informationmanagement staff.

In Arizona, new staff receive two weeks oftraining on the various child care programsand how the MIS is structured. Workers learnhow databases are linked through key indexfields and how edits in one system affect theother systems.

In New Jersey, staff of the community-based organizations (C80) who use thesystem to administer child care subsidy

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programs, received four days of training onprogrammatic and financial functions. Thedevelopment contractor conducted twotraining sessions in the State capital, with halfof the counties attending each session. Inaddition, State child care and informationmanagement staff spent a half-day at eachcounty site training local staff on the system.The participation of State staff from bothoffices was critical because, in the course ofthe computer training, many trainees askedquestions about CCDBG policies andprocedures. The involved CBO's arep'-edominately Child Care Resource andRt.terral (CCR&R) agencies) whose staff alsoreceived ongoing training, technicalassistance, and retraining as necessary fromState MIS specialists.

Security and Confidentiality

Data security is a critical issue in themanagement of a child care MIS, sincefinancial fraud and confidential informationabout families' financial status could invitecomputer intrusion. To help ensure thatappropriate staff have access to only theinformation they need, States have developeda variety of security levels for different data.This, in effect, customizes each user's abilityto either read or enter data in each module.For example, the security system may onlypermit a receptionist at a local CCR&R to readinformation on providers. A caseworker, onthe other hand, might be able to both readand enter confidential client data.

To handle security and confidentialityissues, New Jersey named a securityadministrator in each CBO/CCR&R. Thesecurity administrator acc::sses all informationin the system, controls access to data by eachstaff member, and has the authority to assignand change passwords that provide access tothe system.

Oregon has developed a security systemthat allows each category of user to have adifferent level of access to the system.Contract agencies, such as CCR&Rs, must beissued a license to use the system.

Help Desks

Even with good training, MIS users frequentlyneed help as they learn the system andperform non-routine operations. SeveralStates use "help desks" for providing ongoingassistance to users. Oregon, New Jersey, andArizona provide several forms of assistance toMIS users. A centralized help desk, staffed byState MIS staff is also available. Help deskstaff can display the field worker's computerscreen on their own computer, view what theworker has done so far, and thentroubleshoot over the phone. Arizona alsohas a permanent users' group, which includesmembers from each district in the State andacts as a resource to field staff as well asproviding peer support.

System Functions

The key question for any MIS is, 'What does itdo?" This section reviews functions commonamong most of the five State systems. Threeof the systems reviewed were underdevelopment or only partially operational atthe time of the site visits. Consequently, thecomments from States reflect a somewhatlimited experience with a child care MIS.

Each State's MIS offered some or all of sixseparate functions related to suusidized childcare:

Determine eligibility

Maintaintlient case information

Maintain provider information

Issue payments

Produce reports

Exchange information with other systems

Determination of Eligibility

Many States try to keep the intake process veryflexible to accommodate the differentsituations of potential clients. Several Statespermit applicants to apply in person, bytelephone, or by mail-in application. For in-person and the phone applicationL,caseworkers can enter data directly into theMIS while the client waits.

According to Arkansas plans, State workerslocated at child care centers, departmentstores, and malls will use notebook PCs andportable printers to enroll new clients.Clients will know immediately if they qualifyann will a receive a certificate printed on thespot.

New Jersey and Oregon decided to uselocal CCR&R's or other community-basedorganizations as intake point... New Jerseyhas equipped 21 community basedorganizations with PCs and a locally baseddata system to offer eligibility and paymentservices. The staff of these organizationshave been trained to conduct the initial intakefor subsidized child care. During a pilotprogram, Oregon placed State staff in CCR&Roffices with terminals to conduct intakeinter% -.tws, access the mainframe to determineeligibility; and issue certificates. Now that theprogram has been implemented, CCR&Roffices are being equipped with terminals, andstaff are being trained to assist clients to applyfor services and to troubleshoot paymentproblems.

Eligibility determination involves severalseparate activities and the collection of certainkey information, including basic data aboutthe family and children, the need for services,income eligibility; and identification ofpotential funding sources to pay for theservices. The ease and accuracy with which aselection of funding sources for a family/childis made is directly related to the fundingstream requirements and the family, child,provider information that is collected, stored,and available for use.

Some systems permit instantaneousdetermination of family eligibility. When

eligibility rules are built into the system, theMIS performs calculations automatically andcan set funding source selection priorities. Achild care specialist in Maryland reported thatthe use of the MIS reduces intake time frorrione hour to 20-25 minutes per client.

In Arkansas, the MIS calculates virtually all"decision. points" about a family's eligibilityand selection of child care. That is, thesystem assesses information about the familybased on programmed policy guidelines anddetermines which options are available. Sincethe child care MIS closely interfaces withother data systems, caseworkers do not haveto repeatedly re-enter commonly collecteddata on clients.

In Arkansas, the "authorization/eligibility" moduleassists case workers in determining eligibility andidenifies all eligible funding sources for thecaseworker. The MIS automatically assigns priorities

and appropriate funding sources, lists accessibleand available providers, and pints a certificate foreligible clients at the end of the intake session.

Maryland also has an intake process that isalmost completely automated. When a clientrequests services, a caseworker enterspertinent key information into the MIS andassigns a category code for the type of careneeded. The MIS processes this information,determines the client's eligibility status, andassigns a funding priority.

Maintain Client Case !nforrnation

The case information component of the MISmaintains required data (address,demographics, income, etc.) on each familyand child. When used in conjunction withfunding stream data the MIS can automateeligibility updates and assist programadministrators in planning and monitoringservices. The MIS can also determine changesin overall caseloads and client characteristics.

Although case management was not acentral concern of most of the MIS design staff

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when most States began planning, severalStates have reported that client information inthe MIS is used for case managementpurposes. Oregon's system was designed todetermine eligibility and sends notices toclients for periodic reviews of income andeligibility. The MIS also generates notices if aparent is not using authorized care or makingco-payments. In New Jersey, program officialsexpect that full implementation of their MISwill allow program counselors to spend lesstime on data management and more timecounseling parents.

Arizona's ALERTS subsystem interfaceswith several social services automatedsystems. As a result, changing information inone of these systems automatically informsthe child care MIS of a change in client status.For example, if a JOBS caseworker changedthe employment status record of a client, analert would be generated for the child carecase worker to redetermine eligibilityCaseworkers expect that when the system'splanned feature of generating automaticnotices to parents and providers isoperational, they will have 20 percent moretime to perform actual casework with clients.

Maryland's Child Care AdministrationManagement Information System and NewJersey's Child Care Automated Resource and

Child Care Provider SystemEmployer ID number,Name

Mailing and nos/denten address- Directions for getting to the site- and school district loin- Compliance issues- Provider characteristics (e.g..

demographics, training)Free-form comments about provider

Eligibility System also perform client caseupdates automatically which caseworkers havefound useful for tracking clients. Forexample, in Maryland, when a child turns twoyears old, the system recalculates paymentrates and notifies the caseworker and thechild care provider of the action. In NewJersey, CARES automatically readjusts ratesand recalculates parental co-payments when achild turns two and a half. CARES alsoautomatically adjusts service needs for school-age children based on the public schoolcalendar, so that the child receivesauthorization for part -time services during theschool year, but full-time care during thesummer and holidays.

Maintain Provider Information

The provider component serves two mainpurposes: linking families with providers whomeet State standards and facilitating paymentsto authorized providers. Provider modulestypically incorporate information on providerlocation and size, charges (or rates paid),licensing or registration, services provided,hours of operation, payments made, andchildren enrolled and attending as well ascomplaints about the provider made to thelicensing/registration agency.

i.. 1 ,*. .: pate Mamma.: : , ...

- Standard fees and special charges

Ages of Children in care.. . ... ......

Hours of operation..".. Special capabilities (e.g., ladlitissfor

special needs children)

Licensing Database

if List of providers meetingclient' a needs

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BEST COPY AVAILABLE

As illustrated above, in Arizona, twomodules maintain information on providers.The MIS interfaces the child care providersystem and the licensing unit's database,which allows case managers to obtain on-lineinformation about provider characteristics.For example, if a client needs help finding aprovider convenient to his or her home orjob, a caseworker can search both of theprovider databases by ZIP code and create adetailed list of all of the nearby providers whocan provide the type of child care needed.

Some States have chosen to build onexisting provider databases maintained byCCR&Rs. The Oregon CCR&R staff compareState-generated lists of approved providerswith their own database, thereby expandingthe information that is available to clients.Similarly, in Maryland, data on licensedproviders is transferred to the State MIS fromthe CCR&Rs' databases.

Arkansas' MIS can provide clients lookingfor child care centers and other regulatedfamily child care homes with information onfinding a choice of accessible and availableproviders by printing a hard-copy list ofproviders by county or ZIP code. The list canalso include information on license violationsand complaints within the current reportingperiod.

Issue Payments

Resolving billing problems in a manualpayment system often takes a long time,leading to slow payments and frustrated childcare providers. In the five States visited, thechild care program administrators worriedthat new providers would be reluctant toparticipate in their programs if paymentdelays continued. What they have found isthat a well-designed payment component ofthe MIS can speed payments and make theinformation more useful by:

verifying authorization for payment;

creating a payment history for eachprovide :

reconciling payment with invoices; and

recovering unwarranted payments andadjusting underpayment.

Arizona MIS staff indicated that theirpayment process is now 99 percent error-free.When caseworkers process authorization orbilling information, the MIS cross-referencesall of the information in its databases,simultaneously verifying the information. Thesystem catches and corrects virtually all dataentry errors. Eliminating errors has greatlyincreased the speed with which providers arepaid.

Produce Reports

An automated child care MIS generatesmanagement reports for local and Stateagencies, fiscal and statistical reports for Stateand Federal oversight, and system- andworker-generated reports for information andclient assistance. These reports enablecaseworkers and administrators to monitortheir programs and assign payments to theappropriate funding stream.

Each of the State systems studied hasreport generation capabilities. Systemdesigners decided to have the MISautomatically create the following Federalreports:

Although State staff are generally verypleased with their systems' capability togenerate Federal and State reports, somerealize more work is necessary to betterorganize the claims process and maximize theuse of Federal resources. In some States, staffenhanced the reporting capabilities of the MISin order to provide a variety of other types ofneeded information, such as ad hoc statisticaland management reports for case managersand program supervisors, reports respondingto legislative issues, and reports to studypayment and utilization of different types ofcare.

ACF-231

ACF-115

ACF-700

SF 269 OR 269A

FSA-108

IRS-1099

Exchange Information with OtherDatabases

Another important function of a MIS is toautomatically exchange information, includingmaking referrals, with other systems anddatabases. Some of the databases with whichthe five child care system exchangeinformation on-line are FAMIS, CCR&Rs,AFDC, JOBS, the Food Stamp program,licensing and registration, and child welfareagencies. The extent to which the child careMIS shares data with other systems also varies(see box).M1111,

State Data Sharing

In Oregon, the MIS and CCR&R systemsexchange provider information. The CCR&Rs

receive basic provider information, and the MIS

obtains data on paymerit rates and parent co-payments.

Arizona's system interfaces with its FAMIS,JOBS, and Food Stamp databases.

The Arkansas MIS provides immediate on-line

access to JOBS and Food Stamp databases aswell as FAMIS. Clients who participate in anyone of these programs do not have to provide

basic information about themselves. Thesystem uses identification numbers to matchexisting records, and uses existing :!ata to create

a new record for the child care MIS, freeing up

caseworker time.

Several systems also have linkages to Statecriminal information systems for child careprovider background checks. However, theselinkages do not provide direct on-line access.Instead, data is exchanged and compared bywhat is known as a batch process. Pieces ofdata are grouped and held until they can beexchanged or linked by means of occasionaltransfer, rather than interactively. For largevolumes of data, the batch process is moreefficient than individual exchanges of datawhich can tie up or slow down computernetworks. For example, batch files are oftenprocessed automatically late at night, whenthe system is not used as heavily.

In Oregon, the child care agency staff enterthe names of all new providers into the MIS.Once a week, the MIS creates a batch file ofthese names and sends the batch to the childcare licensing agency to review lawenforcement data system and child abuserecords. The child care agency refuses toconsider the provider eligible for payment ifthe provider or someone associated with theprovider does not pass the records check.

Other Features: Telephone and ModemSubmission of Bills and Pre-authorization ofBills

Presently, Arkansas providers receive hard-copy certificates from parents. Each certificatehas five "tear-off" bills that the provider fillsout and the parent signs. The providers mailthese bills to the State finance unit forprocessing. The Arkansas MIS, when fullyimplemented, will allow providers threebilling options: (1) continue the currenthard-copy process; (2) enter payment datadirectly into the State MIS via modem; or (3)enter data into the State MIS using a touch-tone telephone payment system.

With the last two methods, error-checkingroutines in the computer program willidentify billing errors quickly. Pr\ .eiders willbe notified of billing problems within 24hours and allowed to correct themimmediately, which will reduce paymentdelays and provider frustration.

Oregon's MIS generates a monthly Child CareBilling Form for each provider to submitclaims. The form pre-authorizes billing foreach family and eligible children and lists co-payments. Each form has a unique vouchernumber to prevent the form from being usedmore than one time. At the end of the month,the provider has each parent sign and date theform and mails the form to the Direct PayUnit, where the claim is entered. Typically, theDirect Pay Unit issues checks within one dayafter the form arrives. The State has a 24-hourtelephone line to allow providers to check thestatus of child care provider payments.

Oregon' s System forProvider Information by Telephone

Punches in ID number

41119441.,g17P4TT,F" tY

Listens to a message telling if voucher

- Has not been keyed into system

- Needs more information before processing

Has been processed and check sent

- Has been denied

New Jersey uses a different approach: a"prospective" payment system. The systemmakes automated monthly payments toproviders in advance. When providers jointhe program, they receive an initial payment.At the end of the first month, and eachsubsequent month, a voucher signed by botha parent and the provider must be submittedto the CCR&R for processing. Attendanceinformation is entered into the MIS andadjustments to payments, if necessary, areautomatically made on the following month'scheck by the CCR&R staff. Generally theproviders are paid in full for the entire monthby the 10th of the month.

Critical Issues and Lessons Learned

Every State experienced its share of difficultiesand successes in the planning, development,and implementation of its automated childcare system. Child care and MIS Staff fromeach of the five States were asked what issuesand problems other States should keep inmind when designing a child care MIS. Thissection summarizes those suggestions.

Take time in the planning stages.

Oregon first implemented a pilot version of itssystem in order to predict needs andproblems before going statewide. The resultsof the pilot indicated the need for moretraining time, better policy procedures,improved communications, andaccommodation for a greater volume ofproviders and clients. Arkansas staff advisedthat having adequate time for systemdevelopment was essential, and emphasizedthe need for a schedule to ensure that thesystem will be implemented within set timelimits. Both New Jersey and Maryland foundthat implementing the system in phaseshelped resolve problems as they developed.

When implementing and developing aMIS, ensure close communicationbetween policy and systems developmentstaff

States stressed the importance ofcommunication among policy and systemsstaff and that both speak the same language.Many of the States recommended creating acommittee that includes both program andmanagement information staff to oversee theplanning and development of the overallpolicy decisions for the MIS. States alsorecommended that a liaison be selected tomanage day-to-day contact between policystaff and programmers. The liaison staff (the"translators") should be chosen for theirability to describe computer system functionsin a language that program and policy staff

lb

can understand and describe programfunctions in a way that system staff orprogrammers understand. State staff alsorecommended that the liaison staff be"people-oriented" rather than "computer-oriented." States stressed the importance ofscheduling regular meetings throughout theplanning process. Frequent meetings aremore useful for resolving differences betweendepartments and agencies because they forcecommittee members to resolve problemsrather than placing them "on the backburner."

Involve the user at all points ofdevelopment.

Input and buy-in from users need to beabsolute priorities from the very beginning ofthe planning process. Although the Statestried to involve users, many users still felt thatthey did not have enough input into systemdesign. States recommended that MISdevelopment staff understand users' dailyactivities and what regulations and proceduresthey must follow. Obtaining this informationfrom users will enable the MIS staff to designa system that reflects the needs of the usersand also allows MIS staff to explain to usershow the system can ease their workload. Inboth New Jersey and Maryland, including locallevel staff in the planning process wasconsidered essential because so muchresponsibility for operating the system will beplaced on them.

MIS staff need to understand existingchild care policies and procedures.

MIS programmers and systems staff need tolearn and understand what is involved withchild care services and policies prior toinitiating the design for the MIS. The needs tobetter operate child care programs shoulddrive MIS development, not the needs of theprogrammers.

Obtain commitment from high-levelprogram and MIS staff prior todeveloping the MIS.

Several States recommended that all personsinvolved in the design and implementation ofthe system make a commitment to the project.Commitment from persons at the top levels ofthe organizations is especially important,since problems arising during the design andimplementation stages will require additionaldecisions from top management.

Resolve as many policy differences aspossible before developing the automatedsystem.

Agencies should resolve and clarify policy inthe very beginning of the planning anddevelopment process. States recommendedthat the policies and definitions used byvarious department and agencies involved inthe MIS be clearly articulated in writing asearly in the developmental process aspossible. Failure to do so may result in asystem that does not meet the expectations ofpolicy makers or users.

Design the system to meet specificneeds of State, clients, and providers.

State staff indicated that directly borrowinganother State's MIS probably will not work.States take different approaches to servicedelivery (e.g., State versus county- based,mode of payment, and relationship to FAMIS).They shared that the main reason fordesigning their own systems was theirparticular situation had unique aspects thatcould be best addressed by building theirsystems from the ground up. For this reason,Maryland staff explained, States need tounderstand that technology should be tailoredto specific State needs. The needs assessmentand feasibility study should identify existingsystems (such as FAMIS and child welfaresystems) and decide how and where to link orbuild on those systems.

Design the system to be flexible

Child care policies are constantly changingand the MIS will need to be adapted to reflectthese changes. Designing the MIS to beflexible is critical; minor policy changesshould not force major re-programming.Designing it to link with other relevant Stateand county databases is also important.

Expect delays in the time required todevelop an operational system.

Staff indicated that the system almost alwayswill NOT work perfectly the first time. Statesshould prepare for delays. Also, testing thesystem is critical, and generally = Ices longerthan expected.

States reported that the greater the level ofintegration of each system with other data

systems, the longer the development time.Programmers must learn how the othersystems work in order to interface with them.Some States indicated that the lack of directaccess to other systems inhibited testing andcaused delays. To avoid such delays, Statesrecommended developing procedures toallow programmers to test system interfacesand ensure that programmers have updateddocumentation on each system.

Plan for comprehensive training.

State staff idendfi.ed the training of users as acritical factor. Many users will have few, if any,computer skills. Throughout the variousphases of development and ongoingoperation of the MIS, technical and programtraining for both the child care and technicalsupport staff should be provided.

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1 '3

Appendix BSummary of States' Organizational Structure of Child Care andMIS

ARIZONA

Created in 1991, the Child CareAdministration (CCA) administers the childcare system in Arizona. The CCA is one ofthree components (Child Welfare, Medical,and CCA) of the Division of Children andFamily Services (DCFS), which is itself one ofsix program divisions (DevelopmentalDisabilities, Child Support, Benefits andMedical Eligibility, Employment andRehabilitation, Adult and Aging, and theDCFS) within the State's Department ofEconomic Security (DES). Formed in 1973,DES joined separate agencies--welfare,manpower demonstration, vocationalrehabilitation--under one umbrella agency.The CCAs links closely to the Employmentand Rehabilitation and Benefits and MedicalEligibility divisions.

Arizona's fully operational child caremanagement information system, "ArizonaSocial Services Information and StatisticalTracking System" (ASSISTS), partiallyintegrates with the FAMIS system. The systemdesigners identify it as "somewhere betweenan integrated and modular model." Thesystem is mainframe-based, with county andState workers communicating with themainframe through terminals. The systemincludes AFDC-employed child care, JOBS,TCC, At-Risk, and CCDBG.

For more information contact:

Bruce LiggettArizona Department of Economic SecurityChild Care AdministrationBox 6123, 801 APhoenix, AZ 85005-6123602-542-4248

ARKANSAS

Arkansas' child care system, a State-administered and State-delivered system, isadministered by the Division of Children andFamily Services (DCFS), one of elevendivisions of the Arkansas Department ofHuman Services (DHS). DCFS is responsiblefor child welfare services such as ProtectiveServices, Foster Care, Adoptions, Child CareLicensing, IV-E Eligibility and Day CareEligibility. The DCFS has been responsible forchild care. However, when DHS wasreorganized in 1986, the Division of Economicand Medical Services (DEMS) was created.This Division is responsible for AFDC andtherefore now administers Arkansas' JOBSprogram, Project Success. The Arkansas EarlyChildhood Commission, through theDepartment of Education, works in closecooperation with DCFS administering CCDBG25 percent funds. The actual administrationof child care services within DCFS resides inthe Day Care Eligibility Unit, which isresponsible for administering CCDBG fundsand At-Risk funds.

Arkansas expects its "Automated Day CareSystem" (ADCS) to be implemented statewideby June 1994. The system is somewherebetween an integrated and a modular system.The ADCS shares data with other subsystemsof FAMIS (AFDC, Food Stamps, and JOBSsubsystems). 11,:: system is PC-based, withfield staff using notebook computersconnected to the mainframe computer at the.,sate level. The system began field testing inAugust 1993.

For more information contact:

2

Bobbie FergusonDepartment of Human Services103 East Seventh StreetLittle Rock, AR 72203501-682-8947

MARYLAND

Maryland child care services are State-administered and county-operated anddelivered. At the State level, services areadministered by the Child CareAdministration (CCA), which is under theDepartment of Human Resources (DHR), anumbrella human services agency. The CCAbrings together the State functions related tochild care: licensing, program development,program standards, and program support.Income Maintenance Administration, also inDHR, administers the AFDC program.

Maryland's system, the Child CareAdministration MIS (CCAMIS), is only partiallyoperational. The CCAMIS currently operatesas an independent system. However,Maryland plans to interface CCAMIS withFAMIS, which is under development, at a laterdate. The system is based on a minicomputerconnected to the State mainframe computer.End-users, caseworkers in the countyDepartment of Social Services, use 3270-typeterminals to access the system.

For more information contact:

Barbara Smith-HamerDepartment of Human ResourcesChild Care Administration2701 North Charles StreetBaltimore, MD 21218410-767-7063

NEW JERSEY

New Jersey has a State-administered, county-delivered service system. At the State level,child care services are administered theDepartment of Human Services but areprovided by two divisions, the Division ofFamily Development (DFD) and the Divisionof Youth and Family Services (DYFS). TheDFD is the lead agency for the CCDBG and isresponsible for administering the majority ofchild care programs--CCDBG, At-Risk, JOBS,7'CC--and the State's contracts with 21 county-based CCR&Rs. The DYFS regulates child careand administers child care contracts (TitleXX).

New Jersey's Child Care AutomatedResource and Eligibility System (CARES) wasfully implemented in November 1993. Theindependent system currently has noconnection with FAMIS, OMEGA (the MIS thatcontains JOBS information), the CCR&R's MISor the Licensing MIS. However, New Jerseyplans to interface the CARES with these MIS ata later date. The personal computer-basedCARES system is a stand alone system but hasthe capability of backing up data to the Statemainframe computer via communicationssoftware. The system operates locally withpersonal computers being located at 21county-based community organizations(mostly CCR&Rs).

For more information contact:

Terry CastroDepartment of Human ServicesDivision of Family Development3 Quaker Bridge Plaza, Bldg. 3Trenton, NJ 08625609-588-2282

OREGON

Oregon's subsidized child care services areState-administered and delivered at thebranch Oregon has historicallyemphasized both local decision-making andcross-agency responsibility for child careservices. Four agencies have primaryresponsibility for child care. The Adult andFamily Services Division (AFS) within theState's Department of Human Resourcesadministers the following child careprograms: Aid to Dependent Children (ADC),JOBS, At-Risk, Transitional Child Care, and thecertificate program part of CCDBG. Theagency administers the certificate programcombining the employment and related childcare subsidies into a seamless program. TheDepartment of Edy.,:ation administers theUSDA Child Care Food Program, school-agechild care, and the early childhood education/early intervention program. The Child CareDivision, within the Employment Departmentis the lead agency for CCDBC), licensing,advocacy, and direct child care services tohigh-risk populations. The OregonCommunity Children and Youth ServicesCommission works with communities toidentify child care needs and to plan localchild care programs and initiatives. Thedesign of child care service delivery systems in

Oregon is based on an assessment of localneeds and available resources through acollaborative planning process. In an effort toexpand access and avoid stigmatizingsubsidized child care, AFS, CCR&Rs and otherlocal child care agencies formed apartnership. The CCR&Rs provide a numberof child care services including consumereducation, technical assistance to providers,and research on child care issues. They canalso serve as the intake points for familiesand, in some cases, as outstation bases foreligibility determination and casemanagement.

The fully operational Oregon child careMIS is an independent, stand-alone system.The State has no FAMIS system. Caseworkersaccess the mainframe-based system viaterminals. The system is composed of threeindependent but linked sub-systems: theClient Maintenance System (CMS), the ServiceAuthorization System (SAS), and the ProviderPayment System (PPS).

For more information:

2

Janis Sabin ElliotOregon Employment Departm-875 Union StreetSalem, OR 97311503-373-7282