Pennsylvania: Keystone Babies

Dec 02, 2011


The Keystone Babies program was created to expand access to high-quality early learning settings for vulnerable infants and toddlers in Pennsylvania. Funded by the American Recovery and Reinvestment Act (ARRA), the voluntary program offers financial support to center-based providers to create additional slots for low-income infants and toddlers in the state\'s child care assistance program, Child Care Works (CCW). Providers must be at the STAR 3 or STAR 4 level in the state\'s quality rating and improvement system (QRIS), Pennsylvania Keystone STARS, to participate in Keystone Babies.

Keystone Babies was launched in the spring of 2010 in response to recommendations by the Pennsylvania Infant-Toddler Systems Committee, a subcommittee of the state\'s early learning advisory council, to promote the healthy growth and development of the state\'s infants and toddlers. The Committee recommended developing a statewide infant/toddler program with a focus on ensuring that the most vulnerable infants and toddlers received high-quality early learning services. At the time of Keystone Babies launch, more than a third of the state\'s infants and toddlers were exposed to multiple developmental risk factors. Yet, less than one-fifth participated in quality early childhood programs, such as Early Head Start and Keystone STARS.

Identifying Infants and Toddlers with Developmental Risks

The Pennsylvania Office of Child Development and Early Learning (OCDEL) conducts an annual Program Reach and Risk Assessment on the state\'s young children, birth to five, and their families. In the assessment, demographic data, such as household income and parent education, as well as data on the use and availability of early childhood programs and services are collected and reviewed. According to the 2008-2009 OCDEL Program Reach and Risk Assessment Report, more than 400,000 infants and toddlers, birth through age two, lived in the state. Of these infants and toddlers, only 19 percent received publicly-funded early childhood services.[1] Among the report\'s findings on infants and toddlers:

  • Eight percent of infants and toddlers were served by the Nurse Family Partnership home visitation program, Parent Child Home Program, or in Early Intervention programs.
  • Seven percent of infants and toddlers received child care assistance; another 400 infants/toddlers were on a waiting list for a subsidy.
  • Ten percent of all infants and toddlers were in a child care setting participating in Keystone STARS.
  • Thirty of the 67 counties in the state, or 45 percent, had Early Head Start programs.

Informed by this data, Keystone Babies aimed to create about 200 new infant/toddler program slots. Twenty-six counties and cities identified as high risk areas were selected by OCDEL in which to implement the program. These communities were identified as high risk based on high poverty rates, low access to early childhood services, and the existing availability of STAR 3 and 4 providers.

Funding Keystone Babies/Grant Awards

Keystone Babies provides financial support to participating providers in the form of grants. Grant amounts are determined by how much a provider is estimated to need to meet the program and quality requirements of Keystone Babies. The maximum grant award that a provider is eligible for ranges from about $25,000 to $67,000, depending on the location of the provider. Providers may also apply for up to $12,000 in additional classroom enhancement funding to purchase equipment and supplies. Keystone Babies grants are in addition to funds that providers receive through the CCW-subsidized payment, the family co-payment, and the Keystone STARS tiered reimbursement rate. Families in Keystone Babies must continue paying the CCW co-payment.

Keystone Babies was created using funds from the American Recovery and Reinvestment Act (ARRA). Given that ARRA funds are one-time funds, the future of the program is at present undecided. OCDEL may continue the program depending in part on the availability of Child Care and Development Block Grant (CCDBG) funds. The supplementary funding will be discontinued as of September 30, 2011 but the enrolled children will still be provided child care (and funded through their subsidy eligibility) in the now-existing classrooms. Applications for the Keystone Babies grant were due in March 2010, final grants were selected in April, and services for children were delivered beginning in May. In total, 30 programs applied for the grant, of which OCDEL funded 17 in 22 locations. The grants directly supported 27 classrooms serving 216 infants and toddlers; other children in the recipient centers, however, indirectly benefitted from the provision of high-quality practice required of the centers.

Promoting Quality and Expanding Access - Program Eligibility Requirements

Keystone Babies was designed to both increase the availability of infant/toddler slots for low-income families and to ensure that the services provided are high quality. To achieve this purpose, providers applying for a Keystone Babies grant must meet the following eligibility requirements:

  • Ages of children: All children enrolled in Keystone Babies must be under three years old.
  • Subsidy participation: All children must participate in the child care subsidy system, Child Care Works (CCW).
  • Keystone STARS: Applicants must participate in Keystone STARS, the state\'s quality rating and improvement system (QRIS), and be rated STAR 3 or STAR 4, the two highest ratings.
  • Program operation: Applicants must operate a full day, full year program. This means at least 8 hours/day of instructional activities or services must be provided for at least 250 days per year. Child care services are to provide wraparound support for at least a 10-hour day.
  • Class size: Classrooms must have a group ratio of 8 children to 2 staff. Classrooms with mixed-age groups are encouraged.
  • Continuity of care: Teachers must be assigned to a group of children and remain with that group from birth through age three, or as long as they are part of Keystone Babies.

Programs are expected to prioritize slots for CCW-eligible children under 2 years old and to use child care waiting lists to fill available slots. The waiting list may be developed internally or provided by the local child care resource and referral agency. Programs are also expected to prioritize slots for CCW-eligible children who have multiple risk factors, such as children in Early Intervention, English language learners, children of teen parents, and families in job training or employment.

Meeting Staff Education and Professional Development Requirements

Each Keystone Babies classroom must be staffed with a lead teacher and a teacher. The lead teacher must have a Bachelor\'s Degree in early childhood education or other approved study, or have a degree in a related field that follows the credit requirements outlined in the Pennsylvania Keys to Quality Early Learning Career Lattice. In the latter case, the lead teacher needs to complete 30 credits in early childhood coursework. For the teacher position, an Infant/Toddler Child Development Associate (CDA) or a CDA and two years of infant/toddler work experience is required.

All staff must complete a minimum of 24 hours of professional development annually that includes preparation specific to the care of infants and toddlers. This training must be provided by an instructor registered in the Pennsylvania Quality Assurance System (PQAS) or other approved program.  PQAS-registered instructors have achieved and maintained certain qualifications to ensure that they provide quality professional development and technical assistance to early childhood or school-age providers.

OCDEL set up a comprehensive professional development framework for Keystone Babies participants to strengthen their skills and knowledge of infant/toddler development and care. The framework includes a broad range of professional development trainings and resources, including:

  • Monthly webinars that center on relationships, social emotional development and reflective practice
  • Pennsylvania\'s Learning Standards for Early Childhood, Ounce Assessment, Environment Rating Scale
  • Infant-Toddler Symposium focusing on social emotional development and featuring the Program for Infant/Toddler Care (PITC), Center on the Social and Emotional Foundations for Early Learning (CSEFEL), and ZERO TO THREE trainers
  • Dissemination of resources on research-based practices that support social emotional development and emergent literacy
  • Technical Assistants that visit classrooms, meet with teachers and administrators, and offer supports as needed.

Implementing Age-Appropriate Curricula/Learning Environment

Providers receiving a Keystone Babies grant must implement an age-appropriate curriculum that aligns with the Pennsylvania Infant-Toddler Learning Standards. The curriculum should have a relationship-based approach and promote children\'s cognitive, social emotional, language, and motor skill development. Providers must also have procedures for ensuring that trusting relationships are developed. This includes supporting families from different linguistic and cultural backgrounds. Activities should be inclusive of children with disabilities and their early intervention plans.

To monitor the quality of the learning environment, Keystone Babies programs will be assessed using the Infant Toddler Environment Rating Scale, Revised (ITERS-R). Classrooms must achieve an overall score of at least 5.25. Classrooms that score below 5.25 will be required to develop an improvement plan as part of their Continuous Quality Improvement (CQI) plan, which is required of all STAR 3 and STAR 4 providers. To help ensure that providers understand the assessment process, providers must attend ERS training.

Promoting Family and Community Engagement

Cultivating relationships with parents and other family members is an important component of Keystone Babies. Providers that are awarded a grant are expected to actively engage parents through various activities. Among them, providers should work with parents to create a learning plan and set goals for their children. They should also provide opportunities for families to continue the learning experience at home. At minimum, four parent-teacher meetings must be organized annually. It is recommended that two of these meetings be held in the child\'s home. During these meetings, staff should go over the child\'s individual progress and provide information about child development. Providers are also expected to be knowledgeable about local resources and services, such as the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), so that they can provide referrals to families if needed. Parents should have the chance to be involved in overall program planning, such as providing input on new policies and procedures.

In addition to promoting parent involvement, providers are required to connect with their local Community Engagement Group or other local early childhood leaders and review the early care and education needs of the community. Providers are expected to work with other local organizations on coordinating child development and family support services. Providers are also expected to partner with community members on increasing overall local awareness about the importance of the early years in child development.

Providing Comprehensive Services

Keystone Babies providers must work with early childhood specialists and consultants to ensure that the health and developmental needs of infants and toddlers in their program are met. A variety of screenings, referral services, and other support must be provided, including:

  • Developmental screenings: Keystone Babies programs are expected to conduct developmental screenings using the Ages and Stages (ASQ) questionnaire.
  • Early intervention services: Programs must coordinate with the Infant and Toddlers and Preschool Early Intervention (EI) programs to support children with special needs. Programs are expected to collaborate with their local Early Intervention (EI) program and strive to have at least 10 percent of children who also receive early intervention services.
  • Health services: Programs are required to meet with a qualified health consultant at least four times a year. The purpose of these visits is to maintain the health and safety of the program and provide ongoing access to health services and support to families, including routine health screenings and referrals.
  • Behavioral health services: Participants must collaborate with certified or licensed behavioral health service providers to ensure that early childhood mental health services are available to families. Consultants must be able to provide follow-up and referral services, including referrals for ongoing family mental health services.
  • Food and nutrition support: Keystone Babies programs must be able to support the nutritional needs of infants and toddlers in their program. Programs may not charge families for formula, meals, or snacks and must follow the U.S. Department of Agriculture (USDA) guidelines on meal planning.

Monitoring Keystone Babies Providers

Keystone Babies has several measures in place to monitor providers for compliance with the program requirements and track child outcomes. These measures include:

  • ERS assessment: Programs are expected to participate in the infant toddler environment rating scale (ITERS) assessments, both the self-assessment and outside-assessment components.
  • Site visits: Program specialists will conduct site visits to monitor providers. In addition, there will be provider meetings three times a year.
  • Data tracking: Providers must participate in the Early Learning Network and enter program information, such as service location, staff, and child attendance into the online database system, Pennsylvania Enterprise to Link Information Across Networks (PELICAN).

Evaluation of Keystone Babies

OCDEL is currently in the process of writing a white paper on the Keystone Babies program. The paper will present findings on the program and participants. All Keystone Babies classrooms have received Environment Rating Scale (ERS) assessments conducted by external assessors. A post-ERS rating will be completed to determine if the Keystone Babies programs has had impacts on classroom environment. Similarly, OCDEL surveyed teachers and administrators about attitudes and caregiving at the start of the program\'s implementation. These participants will be surveyed again after they have completed the program\'s comprehensive professional development framework. Child outcomes will be assessed using data collected through the Early Learning Network.

OCDEL has identified the following implementation challenges in the Keystone Babies program, which would be addressed if program funding is extended:

  • Degree requirement: Some programs had difficulty finding teachers with Bachelor\'s degree and were granted waivers. OCDEL would examine changing the requirement to an Associate\'s degree and adding a professional development requirement to help move teachers towards a Bachelor\'s degree.
  • Teen parent access: The full day/full year service requirement prevented access among some vulnerable populations, such as teen parents who only needed care during the school year or less than 8 hours/day. OCDEL would look at extending eligibility to teen parenting programs and other select programs that provide less than full-time care.
  • Classroom requirements: Classrooms were allowed a maximum of 8 children, all of whom had to be enrolled in Keystone Babies. This caused problems when one child lost subsidy eligibility or reached age three and had to be transitioned out of the classroom. To provide greater flexibility and still promote continuity of care, OCDEL would consider allowing a minimum of four children per classroom to be Keystone Babies.


State Contact:

Sue Mitchell 
Chief, Division of Standards and Professional Development
Office of Child Development and Early Learning
Pennsylvania Departments of Public Welfare and Education
Phone: 717-787-7489


[1] These early childhood services include the Nurse-Family Partnership, Parent-Child Home Program, Early Head Start, early intervention services, and Keystone STARS.

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