Monday, May 17, 1999

Day care for sick kids is new option

Fairfield Twp. center thrives

The Cincinnati Enquirer

        Over 1993 and 1994, Brooke Byington had strep throat 10 times. And each of those times, her mother, Dawn Byington, had to choose between her responsibility to care for her sick daughter and her duty to report to work at Hillandale Healthcare Center.

        “I can't just not show up,” Mrs. Byington, a registered nurse, said. “I had people waiting on me, counting on me every day.”

        The choice was difficult, and the options few. So to counter what she termed an “unfair dilemma,” Mrs. Byington started Kids 'n' Kaboodle Learning Center and Sick Bay — Ohio's first and only child-care center licensed to care for sick children — in Fairfield Township.

Meeting a need
        Just entering her second year of operation, Mrs. Byington can gauge the popularity of such centers by either counting the number of times sick children came to her center — 388 in the last 10 months — or she can watch similar centers spring up across the country.

        “We've had families travel over 50 miles just to come to our mildly sick child care cen ter,” said Mrs. Byington, rattling off surrounding county names. “These services are having an impact, and people are traveling near and far, and their numbers are growing.”

        Mrs. Byington filed Friday with Butler County for a three-year continuance on her one-year waiver to a state law banning sick children from child care. She hopes to eventually get a statewide waiver that would allow her to open centers across Ohio.

        Another company already is branching out across the Southeast with the concept. Get Well Center recently opened in downtown Nashville and plans another four in central Tennessee.

Employers' outlook
        Employers regard sick-child care centers as a solution to reducing employee absenteeism. Yet some parents and child-care experts fear such centers might make employers less understanding when a parent decides to stay home with a sick child.

        The backlash has been around since sick-child care centers first started appearing in the early 1980s. Since then, the centers have grown to more than 300 nationwide, according to the National Association for Sick Child Day Care.

        The debate is new to Nashville, prompted by the opening of the 4,500-square-foot Get Well Center.

        “I think the employer would expect you to be there,” said Lori Hibbett, a single mother and employee at the American Automobile Association in Nashville.

        She has three children, ages 7, 9 and 11. “I tend to be a bit clingy and, especially when they were younger, I wanted to be with them.”

Parents' dilemma
        But for many parents, being with their children could jeopardize their jobs. It could also mean using up vacation days, taking away future quality time together.

        For employers, the centers are a way to stem costly absenteeism. Companies like GE Aircraft Engines are offering full reimbursement to employees who use Kids 'n' Kaboodle.

        “Corporate America has woken up and said: "I get it. I'll pay a little and get two to one back on my dollar,'” said Gail W. Johnson, president of the Richmond, Va.-based National Association for Sick Child Care.

        With the continued tight labor market, sick-child care is seen as an added enticement to recruit and keep employees.

Option or rule?
        It all comes back to what kind of alternatives can be made available to parents, instead of them thinking they have to do one thing.

        The problem comes when the benefit appears more a mandate than an option, said Abby Shapiro Kendrick, a consultant at Boston-based Work/Family Directions Inc.

        “I don't think employers intend to pressure employees, but some workers infer they

        are under greater pressure to be at work when their companies sign up for the programs,” she said.

Unwritten policy
        “I've never heard of a company saying, "You must use this center when your child is sick.' Yet that is always a concern of parents,” said Robin Hardman, director of communications at the nonprofit Families and Work Institute in New York.

        “I'm sure some supervisors within companies are going to use it that way to pressure employees.”

        Although sick-child care centers have multiplied through the years, many have proven tough to sustain financially, according to Ms. Kendrick.

        “You find they tend to be expensive, and parents are leery about taking their child to a center that isn't their typical form of care,” she said.

        Nationally, most sick-child care programs are based at hospitals. Stand-alone centers that rely on walk-ins struggle because parents often can't justify spending $100 a day, especially if they're paying for the child's regular day care as well.

        “When centers are able to set up contracts with employers, they have a much greater chance of success,” Ms. Kendrick said.

        That's the strategy of Get Well Centers, which are based on an insur ance model, rather than a fee-for-service model, said Stephen LoJacono, managing director.

Contracts set up
        Employers pay up front for a set number of spaces each year. If they need more, they are charged additionally, and if they don't use all their slots, they get a credit toward the following year. This way, the center isn't at the caprice of seasonal illnesses.

        Get Well also plans to pursue contracts with regular day-care centers, which can offer their clients the center as backup care for when their child is too ill for regular day care.

        Mrs. Byington's Kids 'n' Kaboodle is a combination center, with about 130 children in the regular learning center and room for 20 to 25 in the “sick bay.” The sick bay has a separate entrance and environmental control system to keep the germs from spreading to the other children.

        There also are registered and licensed practical nurses on staff. Mrs. Byington said she doesn't make any money on the $40-a-day fee for children in the sick bay. It's just a service she knows needs to be provided.

        “It's a win-win situation all of the way around,” she said. “Our system works for all parties involved.”

        Lisa Benavides of The Tennessean conbtributed to this report.


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