While schools and parents deliberate whether it’s safe to send children back into the group setting of a classroom, for some kids there is no choice.
Kids at child care centers and in group homes have been learning and playing in close quarters since the coronavirus pandemic hit. But there is no requirement that operators of those facilities report cases of COVID-19 to the Arizona Department of Health Services.
That means there's no way for parents and caregivers to know the health situation at any given site, putting them and children at risk of being exposed to the virus or contracting it.
It's left to the honor system, said Barbie Prinster, director of the Arizona Early Childhood Education Association, which represents numerous child care centers statewide. “It’s really a business decision,” she said.
Her organization doesn’t have a tally of how many centers have had exposures to COVID-19, the disease that develops from the new coronavirus. But anecdotal accounts abound. One center closed for a month this summer because nearly half its staff tested positive for the virus.
The Department of Child Safety does keep track, reporting 159 children in the foster care system had tested positive for COVID-19 since the pandemic started.
That’s 1.1% of the 14,200 children in the foster care system, DCS Director Mike Faust wrote in an Aug. 7 letter to foster parents, relatives and group home managers who care for kids. None of the cases has been serious, he wrote. (The letter is posted on the DCS website, dcs.az.gov. Look for the coronavirus information page.)
These details aren't required to be reported to the Health Department. DCS says it works closely with the Health Department, but it's unclear if it shares reports of positive cases.
While administrators of child care centers, shelters and schools must report communicable diseases such as measles, meningitis and whooping cough, state policy is silent on COVID-19.
Earlier this month, state officials said schools must report any COVID-19 outbreaks to their local health department. It's part of the protocol for safely reopening schools.
But the school benchmarks don't require any reporting to the state. Child care centers and shelters are also outside the reporting requirement.
“It’s a weird loophole,” said Kelley Murphy, director of early childhood policy for the Children’s Action Alliance. Other states have caveats that allow them to require reporting in the case of emerging diseases, she said.
When she pointed out the discrepancy to the Governor’s Office, Murphy said staffers seemed surprised. Without clarifying language in the rules, she added, “At this point, it's pretty much every man for himself.”
Patrick Ptak, a spokesman for Gov. Doug Ducey's office, said state officials support "timely and accurate reporting of outbreaks" to contain the spread of COVID-19. But he did not elaborate on how that works without a requirement, saying the office will continue to work with DHS.
No clear direction
The benefit of a reporting requirement, health advocates say, is it would link these child-intensive settings with public health officials who can help them cope with an outbreak, whether it be contact tracing or reducing the number of children in a space.
"There's no 'Here's what you must do,'" said Prinster of the early-education association. Some centers have segregated exposed children from those who have not been exposed and kept operating. Others have closed for a few days.
Thankfully, she said, she has not heard reports of widespread cases.
"We're putting our faith in families: If you've been tested (positive) you should stay home," Prinster said.
When nearly half of her staff at a West Valley child care center tested positive for COVID-19, Mary Sue Watson shut it down. The center was closed for most of July while Watson waited for everyone to test negative for the virus.
She said they didn't have guidelines from state or county health officials.
"We've just kind of gone along and listened to what people said," Watson said, adding that early in the pandemic they limited parents to the center's office, reduced the number of children allowed in each room and required teachers and children age 6 and up to wear masks.
In late June, Canyon State Academy reported 23 children and eight staff had tested positive for the virus. It did so in response to a media request, spokeswoman Lynea Hansen said.
Canyon State houses many children in DCS custody. Hansen said she could not comment on how many of the positive COVID cases involved DCS youth, citing privacy. As of early August, the East Valley facility had been medically cleared and no one was in isolation, she said.
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Cautious parents
At the Boys & Girls Clubs of the Valley, positive COVID-19 cases or exposures are reported to the agency's human relations department, and parents and staff are notified, said Cassidy Campana, the organization's vice president of communications and external affairs. The testing company may send a report to health authorities, but the clubs don't, she said.
The clubs work with the county health departments to follow public-health guidelines, she said, and everyone masks up.
Since the pandemic started, the clubs have had a half dozen exposures, Campana said. The clubs serve more than 1,100 children in 20 locations and cater to children of essential workers, from nurses to grocery clerks.
“Our parents have been super responsible," Campana said of the low number of cases. "I think because they are essential workers, they know what’s going on.”
DCS is leading
DCS has developed its own protocols for children in foster and group homes. Murphy of the Children's Action Alliance said the agency is emerging as a leader in the state on how to deal with COVID-19 cases in group settings.
For example, if a child tests positive for the virus, the medical/dental program that covers foster children must notify the child's caregivers. DCS informs its staff and private contractors of their possible exposure.
In group homes, updated guidelines require everyone entering the home to have a temperature check and a health screening. That includes children, house staff and DCS workers.
If a youth in a group home has been exposed to COVID-19 or is showing symptoms, they must be tested and wear a face mask while awaiting test results.
Isolation at group homes
In April, DCS awarded emergency contracts to three group home operators to house children who show symptoms of COVID-19 or have tested positive. The contracts are for $1 million each and anticipate an end date of March 2021, although that is subject to change. At least one contract includes children with juvenile delinquency cases.
At Kim Whattler's five-bedroom group home, the children are isolated one to a room, equipped with books, puzzles, streaming TV and other activities. There are scheduled breaks for eating and accessing to the rest of the house.
Of the 14 children she had housed as of early August, only one, a 3-year-old, had to be hospitalized briefly for respiratory problems. The child quickly recovered, Whattler said.
The rest of the children, while COVID-19 positive, have shown few symptoms other than complaints about a sore throat or a loss of taste or smell, she said.
That has made the quarantine tiresome, especially for older children. While at first they like the idea of their own room with amenities, the appeal fades over long days of feeling locked up when they're not feeling sick, Whattler said.
Another group home operator, Sharlyn Morris, said her home has sheltered only children who have had a COVID-19 exposure. No one, she said in early August, has been sick.
Staffing hurdles
The homes accept children from infant up to age 18. In a statement, DCS said the contracted quarantine homes have 10 beds each, so children can be separated by age and gender.
The children's behavioral-health needs are handled as in normal circumstances, and one-on-one counseling is available, according to the statement.
Both Morris and Whattler said hiring has been a challenge.
“It's like trying to find a needle in the haystack to find people who are willing to work with COVID-positive kids," Whattler said.
The wide range of children's ages, coupled with children who are acting out trauma or other behaviors, complicates hiring. Plus, it's hard to guarantee steady employment, Whattler said, since the limited number of children who have passed through her home are only there for two weeks before returning to their previous placement.
Morris said when she's run a group home in non-COVID-19 conditions, she typically recruits from the ranks of teachers, behavioral-health professionals and nannies. But with COVID-19, she's turned more toward certified nursing assistants and home-health aides.
Likened to a prison
Jason Baker has a son in a group home. He said he was notified in early July that one of the children had tested positive, leading to a quarantine of the entire home.
Baker said his son was locked in his room and only allowed out to use the bathroom. The children ate their meals in their rooms and were offered "bottomless drinks," presumably to compensate for the quarantine.
While the practice appears in line with health guidelines related to isolating people who are potentially exposed, Baker objected to the treatment. He felt only children who tested positive should have been isolated.
"Crooks get treated better than that," he said. "That's solitary confinement and abuse to a kid."
He said when he asked the home's managers how this practice is safe, he got no response.
About this report
An ongoing grant from the Arizona Community Foundation supports coverage of child-welfare issues. To keep up on the latest news about the foster care system, its response to COVID-19 and other topics, a subscription to The Arizona Republic helps support local journalism.
Reach the reporter at maryjo.pitzl@arizonarepublic.com and follow her on Twitter @maryjpitzl
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