It’s hard to dispute the importance of training child-care providers on how to administer CPR or how to properly report suspected child abuse.

But Illinois officials are taking a no-holds-barred attitude toward enforcing the state’s latest round of safety training requirements, threatening to stop paying providers who don’t complete its to-do list in the next 90 days. Advocates worry that the state’s approach threatens a subsidized child-care program that serves 120,000 low-income children. The risk, they say, is further erosion of an already fragile and shrinking web of care, despite growing recognition and campaign pledges by Gov. Bruce Rauner that quality early education is crucial.

“It has been confusing — every letter they send out is confusing,” said Brenda McMillon, who runs a small, licensed center out of her Auburn-Gresham home and moonlights as a health and safety trainer for other independent providers. “I think it is great training, but I don’t like the way it was forced on people. You have to give it time to get it done and make it easy to get done.”

Three years ago, Rauner’s administration forced off tens of thousands of children from public child-care rolls when it rejiggered income eligibility criteria. The state ultimately reversed that decision, but many of those children never returned to the program.

Now Illinois could be headed toward further contracting subsidized child care if it cuts off providers who fail to comply with training rules.

The state began communicating the training protocol in January 2017. The original deadline to comply was Sept. 30.

As of July, only one-quarter of providers had completed the training, according to data provided to SEIU Healthcare, the union representing some of the providers. The state health services department, which administers the program, asked for an extension on a public records request from Chalkbeat for updated numbers and did not provide the request by deadline.

Meghan Powers, a spokesperson for that department, said her agency has sent 10 communications to providers in the last 19 months.

We have also promoted trainings on our website, social media and our child care phone line,” she said. The state also worked through a network of referral agencies to send email blasts and direct mailers.   

“Any privately funded child care center would be expected to be trained in these basic health and safety skills,” Powers said in a written response to questions, “and it’s only fair that children receiving child care through public funding receive the same level of care.”

Illinois’ last communication was dated Sept. 21. The state started verifying providers and gave them 90 extra days to submit any missing proof of training. After 90 days, the state’s letter read, “payments may be withheld.”

Brynn Seibert, the director of the child care and early learning division of SEIU Healthcare Illinois Indiana, said the letters and what have been continually moving deadlines are stirring up confusion and disruption.

“We’ve tried to engage the state about what that training looks like and how the training has been offered to providers, but what we’ve seen is that the state has moved forward without input,” said Seibert. “We’re concerned it is going to result in real chaos in the program and families and kids getting forced out.”

The state’s vast network of early childhood providers was rocked three years ago when Rauner’s administration changed income eligibility requirements for families seeking subsidized care then changed them back.

“That decision had a devastating impact on participation in the program,” said Dan Lesser, the director of Illinois policy and economic justice at the Sargent Shriver National Center on Poverty Law.

As of August, the state was serving about 122,600 children monthly, down 31 percent from 2015, when the income eligibility requirements changed.

Last year, to qualify for a state child-care subsidy, a family of five had to include a working adult and earn an annual household income of less than $51,000 or include a parent enrolled in a college or certification program.  

The number of participating providers plummeted, too. They’re down 56 percent from 2015 to 37,530 in June 2017, the latest public data available. Chalkbeat asked for an updated provider count but did not receive it by deadline.

Illinois developed its new training regimen to comply with a 2014 federal law.

But the way Illinois drafted its latest round of training requirements will harm the program, said Maria Whelan, who runs Illinois Action for Children, the state’s largest referral agency.

“This activity is going to have a dramatically compounding effect in terms of the shrinkage of this critical program,”  said Whelan, whose group administers the program in Cook County, trains providers, and helps connect families with child-care options.  

Whelan says that, beyond shifting deadlines, the reporting system is hard to navigate and requires providers to have access to a computer and internet. Many providers live in rural areas, access the Internet on their phone and only have computer access through public libraries. Or they are grandparents and not technologically savvy.

To qualify for the subsidy, providers also must undergo a home visit by a monitor. The biggest percentage of providers in Illinois’ program — 54 percent in 2017— are license-exempt family members who care for children in the child’s home and whom the state pays about $16 a day. But the state still demands they take the safety training and be visited by a monitor.

“We absolutely support improving quality in terms of care that children receive in all settings, and we have been advocating on that agenda for almost 50 years,” Whelan said. “But we think there is an element of intrusiveness in terms of sending monitors into children’s own homes.”

Her group unsuccessfully lobbied the state to exempt relatives from the requirements, which is permissible by federal guidelines.

Now Rauner is in a tough position, since he has pledged to increase the quality of programs but faces a long list of providers who haven’t met the state’s high bar.

Ireta Gasner, the vice president of policy at the national early childhood advocacy Ounce of Prevention, which is run by Diana Rauner, said other states have run into the same problems with their training requirements. Directors of established child-care centers can make a plan to arrange time out of their day to comply; but that same flexibility isn’t always conferred upon smaller, self-employed providers — particularly those who care for family members at the last minute or for children whose parents work third shift or weekends.

“As states try to formalize more of the child care roles and provide trainings and support, you tend to see some dropoff of people who don’t want to participate in the system,” Gasner said of national trends.

The risk, however, of those states casting a wide net is that advocates then lose contact with families and providers who drop out off the rolls.  

“When their providers are being paid through (the Child Care Assistance Program), we can send information to them about trainings and supports and connect them with other supports for their care,” Gasner said. “But when we don’t know where where they end up, we lose our line of sight into the services they have.”

McMillon, the trainer who runs a center out of her Auburn Gresham home, said that 13 providers signed up for her last scheduled training session, which was set for four hours on September 30. When she arrived that day, only five showed up. “One lady — she just quit,” McMillon said. “She’s a grandmother, and she told her daughter, ‘I just can’t do this.’”