Ohio House Children and Human Services Committee - 3-24-2026

Here.

Ranking Member Lutt. Here.

Representative Brownlee. Here.

Representative Click. Click here.

Here. Representative Fowler-Arthur.

Representative Miller. Representative Odioso.

Representative Ray. Representative Richardson.

Madam Chairwoman, I move to amend HB 647 with L136-3000.

Madam Chairwoman, I move to amend HB 649 with L136256011.

Thank you very much. Good morning. Chairwoman White, Ranking Member Lett, and members of the House Children and Human Services Committee, thanks for the opportunity to present sponsor testimony on substitute Senate Bill 35, legislation that would recognize supported decision-making as an alternative to guardianship for adults with developmental disabilities. Supported decision-making is the process of supporting and accommodating an adult with a developmental disability who is making, communicating, or implementing the adult's own life decisions without impeding the adult's self-determination. A supported decision-making plan is a plan between an adult with a developmental disability, the principal, and one or more supporters chosen by the principal that is formal and documented through a written plan. Supported decision-making plans are a less restrictive alternative to guardianship. They promote autonomy for individuals with a developmental disability while still having the help that they need and support to make their own decisions. These plans allow adults with DD to make their own life choices with help from trusted supporters through a formal agreement to assist with major decisions, such as employment, education, major purchases, etc., while ensuring the person's independence and reducing the risk of any exploitation. Formally recognizing supported decision-making in the Ohio Revised Code would help the state free up its guardianship resources for the individuals who truly need guardians. Although supported decision-making informally exists in our state today, recognizing it in Ohio law would give families a solid foundation for continuing to provide this support, knowing their choice will be respected. For individuals who currently have a guardian but have developed the skills to make some decisions on their own, supported decision-making can provide compelling evidence to the court that guardianship may no longer be necessary. In supported decision-making plans, the supporter shall act as a fiduciary for the principal, and protections are in place for the principal if any conflicts of interest arise for the supporter. The principal may modify or end a supported decision-making plan at any time and for any reason by simply notifying the supporter. Substitute Senate Bill 35 does not require any adult with a developmental disability to enter into a supported decision plan It simply recognizes the practice and legitimizes its use for those who wish to do so The bill also requires that the Department of Developmental Disabilities develop a model supported decision-making plan as well as informational materials about SDM plans for adults with developmental disabilities, family members, and professionals who are likely to encounter a plan. This legislation passed out of the Senate Judiciary Committee unanimously, where we made necessary changes to tighten and clarify foundational provisions of the bill. It then passed out of the Senate unanimously. It's supported by leading advocates for Ohioans with developmental disabilities as well as individuals with developmental disabilities. Thank you again for the opportunity to provide sponsor testimony. I will now turn this over to Senator Reynolds, and we'll both be happy to answer any questions afterwards. Thank you. Thank you, Senator Serino. To the chair, Chair White, Vice Chair Salvo, and Ranking Member Lett, I am here to talk in support of this bill. I'm going to go off script a little bit. I just think that this is a very important step as we support individuals of all abilities to be able to self-actualize. As my joint sponsors said this is a less restrictive alternative per guardianship. And so traditionally we've had individuals with developmental disabilities supported by a guardian because of their mental state. However, we've seen through the years, and I've had many constituents, actually my family's business is supporting individuals with developmental disabilities, and we've seen through the years how they grow and they want to grow and they want to be able to make their own decisions just like our own kids. And because of that, sometimes our roles need to change. We don't always need to approach everything from a guardian or a control standpoint. We need to have coaches. We need to coach individuals to be able to self-actualize and live to their fullest potential. And this is what this bill does. For those who need guardians, that's still a process in place. But for those who would really like to have a trusted circle, people that they trust, folks that they work with, They could be family members or folks that they trust, and they say, I really, you are my circle, just like we have one, and I trust you, and I want to ask you for advice to help me grow. And that codifies this into law and makes it clear that these are individuals that can be supporters of theirs. They have a fiduciary responsibility, and at any time, the individual who is giving that delegated authority is in control of their plan and their own life. And so I just think that from a human level, this is dignifying. I think it helps individuals grow, and it recognizes and respects their opportunity to grow as adults and live up to their fullest potential, and I fully support it. And we're happy to answer questions at this time.

Thank you, Madam Chair. Thank you both for your work on this bill. When I saw that it was going through the Senate, I shared it back with a constituent who had reached out to my office a few years back, actually, with kind of a dilemma that I'd like to pose to you and just see how you envision this working in practicality. So they had a child with severe cognitive disability, a nonverbal adult graduating from school and the Developmental Disabilities Board was pushing that that child become an independent adult and be responsible for making their own decisions even though they didn have the ability to communicate verbally or in writing what their thoughts would be Would this language in the bill make it where that assumption from the board would have been the starting point? The family's concern when I shared the bill back was, well, as the caretaker and trying to make sure that we do respect our child, but also make sure they have the services that they need, how does that actually play out practically when they can't actually verbally or in writing communicate?

Thank you, Madam Chair. Thank you for that answer. I think that does shed a lot of light on it. I guess the one follow-up question that they also posed me was, would anything in this bill help with the cost of having to go to court and getting the guardianship for an individual as far as the family side, or does this mean that every family would have to go through the court process when their child with a disability is graduating?

Ranking Member Lett.

Through the chair. I'm sorry, could you just repeat the question? I want to make sure I got it correct.

Through the chair to the ranking member. I guess that's one of the reasons why we've asked in the bill for the Department of Developmental Disabilities to develop a model document that would be used. And hopefully there would be in that form, there would be a defined process by which if family members, let's say, felt that the developmentally disabled individual in their family who had an agreement was no longer capable of owning up to their share of the responsibilities with that, and that it was necessary to go to the court, they can certainly, would have standing to do that, and basically eliminate the agreement we're talking about in the bill, and go to full guardianship. Okay. It's a great question. Thank you very much for that.

Representative Click.

May I? Yes, please. Go ahead. To the chair, to the senator, thank you for the question. First of all, I'll say that it's also hard for me as a mom to let my boys go, and they're grown. So I get it. And we did hear testimony in committee from concerned parents and loved ones and guardians that said, hey, what if guardianship is necessary? And I can assure you guardianship is not going away. So in the event, that's why I like this bill, because it allows for flexibility. It's not painting a broad brush saying that we only need one way, which is guardianship, to support individuals with developmental disabilities. it is allowing for that continuity. Life is in developmental stages, and so as people grow older and they have more needs, even like our parents, and they age, and you may need to take guardianship or help them and support in their life cycle, that allows this to be so. But when that's not the case, when we have someone who's vibrant and who wants to live and self-autonomy, it allows you to support them in a different way. So that's what I like about this bill is that it gives you those options, and it's a less restrictive way because everybody doesn't need those restrictions, but some people do, so it doesn't take it away. And hopefully that's helpful.

there are individuals with developmental disabilities and advocates and consumers who are very high-functioning, and they're asking, you know, we want to be able to have control of our own lives, the same things that our kids say to us, whether they have a disability or not, and they say, you know, that's too much control. So that, from a consumer level, is coming to us. What we also have, though, is loved ones who are very much concerned, who are like, well, sometimes there needs to be parental control. Sometimes there needs to be a little bit more restriction. And so that's what this allows is that flexibility. It's not saying that we're going to go all or nothing. It's saying we're going to have both and coexist. Now, I'll let my response. Thank you, Senator. So, Representative Click, I think it's a great question. You know, families that are, and we discovered this in discussion with some of the experts and with testimony that we heard in the Senate, that, you know, families where the disabled individual has extremely involved and engaged family members are probably not going to be using these very much, okay? One of the concerns that was expressed to us was individuals who don't have family assisting them in a lot of these decisions, but are still able to make some of their own decisions with some proper advice, that that's probably where this is going to come in most handily. So, again, there's tremendous flexibility in this, and it's not a blanket. You can decide everything for this individual. they can be very narrowly defined. It depends on what the individual situation calls for. Thank you.

Thank you, Madam Chair. Thank you both for your testimony. I've learned a lot even just in a few minutes listening to you, so I thank you so much. My question is really just with regard to the fiduciary duties. I would guess that that's probably where the rub comes in a little bit. So now you have a guardian who has a responsibility for those duties. And the shift goes, if I'm reading the bill correctly, to the supporter. Does that, just to be clear, does that mean the supporter now takes the fiduciary duty over the guardian on behalf of the principal?

Thank you. No follow-up.

since it seems like the family court system is very burdened at the present time, do you anticipate families or individuals who are needing to pursue guardianship or this going through the court process getting timely hearings or it bogging down the system any more than it's currently bogged down? And if so, could we discuss how we might be able to prevent it from becoming another bureaucratic delay in receiving care or updating the care plan?

All right. Thank you both for coming in. This will conclude our first hearing on Substitute Senate Bill 35. All right. Next, we will call up House Bill 537 for opponent and interested party hearings. First, we will have Monica Hickel and Dr. Lisa Bowman-Egbert for testimony. Chairwoman White, Vice Chair Salvo, and Ranking Member Lett, members of the Children and Human Services Committee.

Thank you, Monica. Thank you, Chair White and committee. My name is Dr. Lisa Bowman Egbert. I am a longtime member and a past president of the Ohio State Medical Association. As a soloist in private practice in general obstetrics and gynecology for over 27 years in Dayton, I personally cared for thousands of obstetric patients from their first positive pregnancy test at all of their prenatal visits to delivering their babies and caring for them postpartum. I also managed their general gynecologic well-woman care. As Monica said, I'd like to provide some additional clinical perspectives on HealthSpo 537. It's extremely concerning to me that this bill would allow home births to include vaginal birth after cesarean, or now we call them trial of labor after cesarean, birth of twins, and breech births at home. While we maintain that hospitals and accredited birth centers remain the safest setting for birth, each birthing patient does have a right to make medically informed decision about their delivery. Part of that medically informed decision is being empowered with the knowledge about factors which greatly reduce perinatal mortality risk to both moms and babies. And this includes the appropriate selection of lower risk candidates for home birth. The American College of Obstetricians and Gynecologists Committee on Obstetric Practice considers VBAC, birth of twins, and breech births to be an absolute contraindication to a planned home birth. Because of the distinct and serious risks associated with these deliveries, we strongly recommend that these births occur in an accredited facility or hospital with trained staff that can promptly perform emergency cesarean delivery to avoid needless maternal and fetal risk. There are simply too many predictable and significant complications, including life-threatening concerns, which can arise from these circumstances. These cases require specific medical attention by trained personnel within a narrow time interval to avoid catastrophic consequences. Sometimes, there are no warning signs of these potentially catastrophic outcomes, except those which can only be detected with resources and personnel available in hospitals and accredited care facilities, such as continuous phenomodernary. There is an increased risk of uterine rupture in patients who labor after one or more cesarean births. This is a rare but dangerous and life-threatening complication for both patient and baby. It occurs when the uterus opens at the previous scar. Fortunately, uterine rupture with quick surgical intervention and resuscitation to the baby, most women and babies survive. But such urgent intervention is only possible in the accredited hospital The American College of Nurse Midwives has stated that it is quote safest to have a VBAC in a hospital so you and your baby can be monitored during labor, end quote. At my hospital, for both the safety and the mom, we do not even allow a trial of labor after cesarean to occur without an obstetrician in-house ready for mom and baby. Additionally, House Bill 537 includes language that allows a patient to refuse referral from a midwife to a more appropriate setting for trial of labor after cesarean, birth of twins, or a breech birth. We appreciate a patient's right to choose, but this legislation must account for how to handle the situation and what a midwife should do if they no longer feel comfortable and able to continue the maternity care of a patient who refuses referral. It is imperative that high-risk deliveries take place in settings which are equipped to handle the specific and heightened needs of these patients, including operative delivery. As an obstetrician and a mother who survived two very high-risk pregnancies, including the birth of my own twins, I believe the provisions in House Bill 537 regarding these deliveries pose an absolutely unacceptable risk to patients in Ohio, and it is moving Ohio in the wrong direction. Thank you for your consideration, and we would be happy to take any questions.

Ranking Member Lett. Thank you, Chairwoman. Thank you so much for coming in to testify today. You touched on something that I have been thinking about a lot since I first started reviewing this bill in the section, Monica, that you were talking about, the reporting requirements. One of the things that I'm concerned about with this bill is if you are licensed in some way, shape, or form across the spectrum of the different categories that we're going to license for midwifery, what happens if you lose that license or there's an adverse outcome and you're stripped of your licensure in some way? I'm concerned that this bill then allows you to go practice as an unlicensed traditional midwife and continue seeing patients and the possibility that they would therefore not know that you had been stripped of your licensure. Do you think it would be advantageous or helpful or beneficial really in any way to add that to the reporting requirements that if you have lost licensure, there's a list? Or, you know, I'm thinking about it in terms of, you know, financial advisors. If they do not perform their fiduciary responsibilities, they are then put on a brokerage check. And every time you Google that person's name and look up their track record, you can see, you know, the adverse outcomes that they have had throughout their career. So just wanted your opinion on that and if you think it would be helpful to add. Thank you.

All right. Thank you.

Vice Chair Salvo. Thank you, Chair. And thank you, Doctor. One of my questions is with those high-risk pregnancies in the home environment, do we have any data of what those negative consequences or outcomes might have been in the past, given we don't have a certification process at this time?

Follow-up. Follow-up. Thank you, Chair. So very quickly in summarization, you would be in support of certification limitations around high-risk pregnancies and data collection as we go forward. So that would be a licensure for all midwives. Absolutely.

Representative Miller. Thank you, Chair, and thank you, Monica, and thank you, Dr. Bowman, for coming in for testimony. I have so many questions, which I realize we have a time limit today. I guess maybe overall my very first question would be, given Ohio's maternal care shortages, especially in rural areas, rural Ohio, what solutions would you propose or recommend if we're not expanding midwifery services?

Follow-up? Do you want to go to one? I agree. Okay, very good.

Did you have any comment on that?

Go ahead, yeah.

Thank you. Rep. Richardson, did you still have a question?

Through the chair to the representative, I will just say I was in private practice, so I did not have a midwife group that I was supporting. I can tell you that when I was a resident, we definitely saw those train wrecks arrive at our emergency room door. And, you know, rare, but it happens. I can't give you absolute data because I don't know that we have the data. How do we know when somebody was laboring at home of their own accord without help and things went wrong and they called a squad themselves versus somebody who's been attended by a traditional midwife who called the squad and sent them on their way without being there to help them? So I know that that is not what they say they do, but I do know that it happens and has happened. I don't know the numbers, but one is too many.

Next, we've got two more questions, and then we need to move to the next witness. We have Representative Click, then Representative Bryant Bailey.

Chairwoman White, to the representative.

Follow up. Thanks. So I would think that the physician might ask them that and be able to document that, but you saying the physician doesn ask or they keep that a secret or what do you Yeah chairwoman to the representative yeah we not keeping any data secret in the state of Ohio No not you but the patients But there no requirement

Just would it be possible to have that put in the charts at the hospital to document so there is a checkbox, not just in the patient's data, but say yes, this complication arose due to midwifery? There is no checkbox.

Brian Bailey, did you have a question still?

Yeah, before Dr. Egbert jumps in, Chairwoman White to the representative.

Thank you very much.

Good morning, and thank you for having me, Chair White. Vice Chair Salvo, Ranking Member, Lett, and esteemed members of the committee. My name is Dr. Amy Burkett. I'm an obstetrician-gynecologist currently working as both an OBGYN hospitalist, so I suspect you may bring some of your questions back to me that were asked to the previous members, which is absolutely fine, at an academic teaching hospital and seeing patients both in the office setting and the OBED emergency room at a large academic center. I lived in Ohio my entire life. I received my medical degree from the Northeastern Ohio Medical University, affectionately known as Neomed, and then did my residency right here in Columbus at the Ohio State University Medical Center before returning to Northeast Ohio. I am here today on behalf of the Ohio section of the American College of Obstetricians and Gynecologists, known as ACOG, which represents more than 1,500 OBGYNs across Ohio. and approximately 58,000 OBGYNs and women's healthcare professionals nationwide. I currently serve as ACOG's District 5 Chair Elect. ACOG is the leading organization dedicated to the improvement of women's health, establishing evidence-based standards of care. Our organization is generally supportive of licensing all midwives providing maternity care in the state. We are grateful for the sponsor's inclusion of provisions related to informed consent, transfer liability protections for receiving providers and facilities, adverse outcomes reporting, and pre-registrations of intended home births with nearby hospitals. Many aspects of this legislation are essential to improving birth outcomes for Ohio families. We would like to be supportive. However, we have concerns that led us to oppose the bill as currently written. I will briefly outline some of those concerns. To maintain the integrity of the health and safety components of a midwifery licensing program, home birth must be limited in statute to normal, low-risk pregnancy delivery, postpartum, and newborn care. We are particularly concerned that the bill would allow home births involving vaginal birth after cesarean, multiples, or brief presentation. These conditions are an absolute contradiction to planned home birth. Because of risk associated with trial of labor after cesarean delivery and unpredictability of uterine rupture and other complications, TOLAC should only be undertaken in facilities with trained staff and the ability to begin an emergency cesarean delivery. High-risk pregnancies necessitate they should be undertaken at facilities capable of performing emergency deliveries and neonatal resuscitation. ACON finds the language around pass to licensure in this bill to be confusing with different licensing standards, scope of practice and oversight structures to providers performing similar services. By regulating certified midwives to the Board of Nursing, licensed midwives to the Department of Commerce and allowing traditional midwives to practice without licensure, the bill creates inconsistent expectations for education collaboration and accountability It confusing to the patients which we generally try to avoid These discrepancies risk confusing and the qualifications floor important distinctions in training and clinical capability. The same point, gaps in requirements, such as a lack of uniform collaboration standards and the expansion of certain clinical authorities without clear defined guardrails, raise concerns about care coordination and patient safety, which should be paramount. As this committee has heard in prior testimony, Ohio continues to face challenges with maternal care deserts and infant mortality rates. While gaps in access do exist, bypassing established certification standards does not improve safety. It is essential that all providers caring for birthing persons meet consistent education and training standards. ACOG supports standards used by American Midwifery Certification Board, which credentials certified nurse midwives and certified midwives. We recognize and support a person's right to choose their provider in place of birth. As physician, ACOG wants to ensure patients are making informed choices about their health care. In addition, we want to ensure licensure of midwives in Ohio guarantees a high standard of education is met and the appropriate safety guardrails are in place to ensure the best outcome for women and their families. Thank you for your time.

I can particularly, Representative Glick specifically asked about the data collection around morbidity and mortality and how we collect that. As an OB-ED hospitalist, I am the person who gets the train wrecks that were described, and I will say that we do put that in the charts. I want to be specific about that. The problem is that we have a PAMR, a Pregnancy Associated Mortality Review, so that means that someone has to die to be reviewed at the state level. I work really hard to not have that happen. We do not have a morbidity review. So that would be an adverse outcome that doesn't get reviewed at the state level. So the hospital may review it, but that data doesn't get collected at the state level. So yes, that information is in the chart, but currently it doesn't get collected because we don't license it, right? So we don't collect that data like we do for the physicians right now. This bill with licensure would allow that. So we're not taking away the patient's ability to have the birth that they want and the place they want, but it does allow the collection of morbidity data to happen in a controlled fashion, if that makes sense.

Representative Richardson. Thank you, Madam Chair. And just a quick follow-up. And, you know, you definitely were the person I should have asked my former question of, and I apologize to the previous witness. But I just want to, you know, reshape my question. Is it a legitimate concern that when you are in the ER working and someone comes in who has been, you know, a patient, a person who's giving birth in one of the most important experiences of their life, bringing life into the world, Is it a legitimate concern of the hospitals and the individual staffing there that they are bringing in an individual who had been worked on and that situation could have been prevented because they chose a home birth?

So, yes, I have in my time as an OBED hospitalist dealt with complications that were made worse by the patient attempting or having a delivery that occurred at home,

Thank you. No further questions.

Chairman White, Vice Chair Salvo, Ranking Member Lett and Distinguished Members of this Committee. Excuse me really quickly, I'm so sorry.

My name is Jacqueline Fraley. I am a certified nurse midwife. I understand the types of midwives can be confusing. As a certified nurse midwife, I hold a Bachelor's of Science in Nursing from Kent State University and a Master's of Science from The Ohio State University. I have been a nurse since 1998. I have spent nearly two decades in the birth space and for the last 10 years as a practicing certified nurse midwife I have cared for women in hospitals in rural communities and in out-of-hospital settings I have spent the last nine years as a hospital-based midwife in southeast, Ohio I believe deeply in midwifery care and in a woman's right to choose where and how she gives birth I support community-based midwives. I support families who choose out-of-hospital birth I firmly believe that out-of-hospital birth can be a safe and appropriate option when practiced within clear and evidence-based safety standards. That is why I believe this bill is both important and long overdue. However, I am concerned that as written House Bill 537 does not go far enough to protect women and babies. Specifically, I strongly oppose to the exemption of licensure for traditional midwives who are not for a distinct religious community or indigenous group. When a woman chooses a midwife, she should be assured that her provider has met consistent standards of education, training, and clinical competency. Licensure is the mechanism that provides that assurance. It also provides something equally critical, accountability. When serious complications occur, and they do, there must be a system in place to review those outcomes, investigate causes, and implement corrective actions. Without licensure, there is no reliable way to ensure that preventable mistakes are examined, and we are allowing avoidable harm to go unaddressed. As Dr. Melissa Chaney, a respected midwifery researcher, stated in her proponent testimony in this bill, community births are safest when they are part of an integrated, regulated system with seamless transfer, appropriate risk assessment, and well-qualified providers. The question is not whether community birth occurs in Ohio, the question is whether it occurs within a regulated, integrated system that maximizes safety. In my current role, I have personally cared for patients transferred from community births with devastating outcomes, including cases involving permanent disability and loss of life. In all fatal cases, there was negligence in the care given by the community-based midwife. These included improper use of medications to induce labor, laboring a mouth presentation for days, attempted vaginal birth after two prior cesarean sections resulting in a uterine rupture, failure to recognize and act on signs of maternal infection. We had cases where both mother and baby were lost, and others were just the baby's died hours after birth. When these patients arrive at the hospital, the outcomes become part of the hospital record. The hospital is required to report, review, and implement corrective actions, but the community-based provider is not subject to any formal review, oversight, or accountability. This is a critical gap in our system, and it must be addressed. I want to emphasize, these experiences have not shaken my belief in midwifery or of out-of-hospital birth. Instead, they have reinforced my belief that we must have strong guardrails in place. The state has a responsibility to ensure that families can identify qualified providers, and unsafe practitioners cannot continue to operate unchecked. Under the current language of this bill a licensed midwife could have their license revoked for negligence and continue practicing the very next day as a traditional midwife without oversight and accountability this is unacceptable we would never accept this lack of oversight in any other area of health care We would never say that standards are optional when lives are at stake Licensure is not about restricting access. It's about ensuring safe, competent, and accountable care at one of the most vulnerable moments in a person's life. Midwifery care is essential in addressing health care gaps in Ohio. It is evidence-based. It has strong outcomes. but when practiced within appropriate systems. I respectfully urge this committee to strengthen House Bill 537 by requiring licensures of all individuals practicing midwifery in Ohio.

Representative Brownlee, thank you for your testimony. Through the chair, thank you for your testimony. And just to clarify further on what you and the previous witnesses have stated,

Correct.

Okay. Any other questions for this witness? Thank you for coming in today. Thank you. Next up, we'll call Ms. Bambi Chapman.

Thank you, Ms. Chapman, for your bravery in sharing your story. Are there questions for this witness? Okay, thank you. Your story stands without question. All right, next up we will have Renee Yeager, who will be our final witness.

Thank you very much for your testimony. We probably are out of time for questions, but we can review. You left a few things out, and we'll read over that again. And I do appreciate it that you came in. So this is going to conclude the third hearing on House Bill 537. I do want to ask, if you don't mind, and again, I apologize. Things just took a bit longer than we expected. How many people are planning to come back and testify this afternoon? Could you raise your hands? Will you have some individuals too? Okay, all right. Kaylee will be sending out an updated notice as soon as we get the time frame, which should be somewhere between 2.30 and 3 o'clock that we would start. We will be in room 116. You'll see it on the notice. Again, I thank you for your patience, for everyone attending. Thank you for the people who came in and testified today. And seeing no further businesses, we're going to recess for now. Did you all have fun? And we will then begin testimony on 647 and then 649 We will allow five minutes testimony for each witness okay Since we back in a mode we not as rushed but we will have a five-minute limit and we will begin. So first to start off, 647. We need to take roll. No, we don't take roll. This is a new thing. We will first call up Karen Lampe with the Association of Child Care Providers of Ohio as interested party. Thank you, Karen. Thank you, Chairman White. Chairman, Vice Chair, Salvo, Ranking Member Lett, and members of the committee,

Vice Chair Salvo. Thank you, Chair, and thank you so much for your testimony. My question to you is if we then went back to that 30-day for back tap, are you comfortable where this bill is now? Are there things that could help the child care providers at this point? Any other recommendations for us?

Can I have a follow-up? Sure. Thank you, Chair. I've been speaking with some of my colleagues, and I think there's a difference across Ohio on size of child care providers. In my district, I've received feedback that the facial recognition on the child

Okay, I'm seeing from your face.

Okay, thank you. Through the chair, thank you.

With after-school care or school-age kids, can you just walk us through the process? Because kids are often just dropped off on a bus from school. So you clearly already have methodology in place to manage this.

Thank you. I think, thank you, Ms. Lampe, for coming in. I did want to ask, can you just walk us through, I think just so we all understand, with the school age, you're only tapping in, you're not tapping out. Or are you tapping out as a student as well?

Okay. Yes All right In terms of the back taps and the reality of that right now what percentage of parents are you chasing down I mean are parents not coming in Practically speaking are they not coming in when they drop their child off

And if we're creating a system, you know, to go back to your question, Representative Salvo,

Okay. And then just to add on, thank you for that answer. If, in fact, you had a shorter time window, but the ability, I guess I'm trying to think,

And so we just need time, and especially for moms that are busy, they're working, they're trying to get their kids and do all the right things,

Okay, and just to drill down, what percentage of people actually does it take you

All right, thank you very much. Thank you. We'll call the next witness up, and that is going to be Leslie Doria. Did I pronounce that right? With the Ohio Alliance of YMCAs. Interested part.

Thank you very much for coming in, Ms. Doriott. Is there any questions for this witness?

I think there's still, sorry, Representative White and Representative, I think there's still some work we could do together on that, and we would really like to see that window stay open to the four-week window.

Just to follow up quickly before we move to Rep. Brownlee, so what other areas of the bill did you want changed besides the back-tapping?

Okay.

Rep. White and Representative Brownlee, yes. So especially for a center, maybe they only have 45 children enrolled that are on public funds. So you are literally one tablet that we're given by the state to do these taps at a period of time. So especially at some of our facilities, you know, there's a heavy drop off in the morning timeline and then a heavy afternoon timeline. You know, a lot of families work kind of similar hours. So you're fighting for that slot at the tablet to kind of get your taps done. So I do think that that plays in where parents are like, oh, there's five people waiting. I'm going to maybe do it tomorrow. And then something else happens and you kind of create a snowball effect.

Rep White and Rep Brownlee. I think that all depends. How many kids do you have in our program? Are you completing any back taps from a previous day? Just a ballpark. A couple minutes per kid, usually, to do that. And if you're, as most of us working moms, sometimes in the morning hours you're really stretching the clock there to get your kid. Or maybe they're just getting their kid to us right before they're getting on the bus to go to one of our other locations. So it's kind of a time crunch there. So it all depends, too, on making sure the tablet's working at that period of time, nothing else is going on. So a couple minutes at least per kid to do that. But could it take up to 5-10 minutes? For sure, depending on how much they're doing, especially if they're entering maybe a week of time that they have to do, things like that.

Representative White, I don't feel that we're probably doing it day to day because we're doing so much other things. You know, most directors are wearing lots of different hats. So, you know, our goal to parents is always to tap daily. And that is what we tell them on a regular basis. That is all communication we send out to them is to tap in the morning and to tap every day. But that's not reality. So it's actually a process where we have to go back then and look at our classroom rosters for the week to make sure that we, you know, and kind of then look into the state system and kind of go through all of those and do an audit to make sure that we've captured everything. So then if we haven't captured those items, exactly what she talked about, we're allowed to do those pending transactions, which I feel like that happens a lot more with school-agers, where a parent would then still have to, we're still going to have to communicate to them to say, hey, you have pending transactions that need approval. And then we, on our side, spend a large portion of time, we have about 350 students currently within my organization that are on public funds. So I honestly have a dedicated full-time staff employee who spends almost every Sunday going through the last week of rosters than to put out an audit to our directors at the center level, and they're then communicating with families via our mass communication system, in person, sending emails, tracking them down, calling people, please come in on your lunch break. It takes a lot of work on a center director, too, than to communicate to every single parent. And sometimes we have to help them. Like, remember, you need to do an out time at this time on this date. And whenever you go back, it's a little bit more complicated in the system to enter back times. So a parent, sometimes we need to help provide them with that information, you know, or show them the roster. This is what time, you know, you left that day. Can you please enter that?

Good afternoon, Chair White, Vice Chair Salvo, Reckoning Member Lett, and members of the House Children and Human Services Committee. Thank you for the opportunity to testify In opposition of House Bill 649 as Chair White said my name is Erica Crawley I currently serve as one of the Franklin County Commissioners House Bill 649 proposes burdensome regulations that create severe unintended consequences for Ohio's working families, children, and small business childcare providers. Franklin County has made significant investments to increase the availability of affordable childcare, and I am concerned that this legislation would undermine those efforts by entangling providers and families in unnecessary red tape. Additionally, Franklin County takes any allegations of fraud or the misuse of public funds very seriously. For example, as you all may have heard last week when Prosecutor Favor testified, Franklin County Department of Job and Family Services collaborates with the Ohio Investigative Unit this past year to identify scammers who stole an estimated $600,000 in benefits, and her office has successfully pursued cases of fraud related to American Rescue Plan dollars. Regardless of whether funds originate at the federal, state, or local level, we are committed to protecting taxpayer dollars. While we prioritize integrity, it is vital to set the record straight regarding the county's role in overseeing child care centers. And I know last week, one of the representatives asked prosecutor favors specifically about county commissioners interfering with investigations to childcare providers. And I wanna say that Franklin County and our JFS office have long been productive partners with the Department of Children and Youth. However, our mandates are distinct. Despite assertions made before this committee, the Franklin County Board of Commissioners and its agencies have no role in investigating centers, nor have we interfered with any such investigations. Quite simply, we do not have the statutory authority to do so. County JFS offices assist in determining eligibility for publicly funded child care for families in need and conduct inspections of at-home providers. County JFS offices conduct twice-yearly inspections of these home-based programs, at least one of which is unannounced. The state, however, is responsible for inspections and oversight of child care centers, and the authority to revoke licenses or closed centers or home-based programs rests solely with DCY. Our JFS office proactively alerts state partners when irregularities appear in the course of determining eligibility or while conducting an inspection for a home provider. But I must reiterate, the state is responsible for investigating potential fraud in these centers, not County JFS, not the Board of Commissioners, and certainly not Internet personalities who have recently attempted to film inside daycare centers in our community. Furthermore, we must consider the climate of fear these regulations create for our local entrepreneurs. Most child care providers are small businesses owned by women and people of color who are already struggling with historic staffing shortages and rising operational costs. By imposing invasive surveillance and administrative hurdles, House Bill 649 signals to these providers that the state views them with suspicion rather than as an essential partner. If these small businesses are forced to close or opt out of the public system to avoid these mandates, the result will be a child care desert that prevents parents from returning to the workforce ultimately stifling Ohio economic growth The child care system in Ohio is at an inflection point The need has never been greater nor has the cost Franklin County is doing its part to ensure affordability by investing more than $43 million in ARPA funds over the past four years in Franklin County Rise Child Care Initiative, providing scholarships for families, incentives for licensed providers, and rental support for workers. We are also demolishing our vacant downtown jail with plans to construct a new early learning center to support the downtown workforce. I care deeply about making childcare safe, affordable, and available while remaining a vigilant steward of taxpayer resources. However, House Bill 649 is a solution in search of a problem that risks the privacy of children and the stability of our providers. I urge the committee to vote no on this legislation. Thank you again for the opportunity to be before you, and I'm happy to answer any questions that you all may have.

Ranking Member Lutt, you had a question. Thank you, Chairwoman. Thank you so much, Commissioner, for coming in and sharing your testimony today. I think one of the great things about Franklin County is the Franklin County RISE program, so I just wanted to know if you could talk to us a little bit about Franklin County RISE and maybe give us some ideas for ways that we could utilize that program to bolster our efforts at the state level. Thank you.

Thank you, Chairwoman.

Thank you for that question. Through the chair to the representative, I think it creates a slippery slope. When we think about the requirements of this legislation, if a provider chooses to opt out, then they could be forfeiting publicly funded child care. and therefore, you know, when it comes to serving families, they won't be able to serve those families that receive publicly funded child care, and so families will have to look elsewhere. I think the other thing that we take into consideration when it comes to this bill, when it comes to surveillance and having to require cameras and then store the data for a number of months, I think the cost of that, child care centers have to bear that burden. There is no allocation or appropriation in this bill that helps child care centers with that, whether it's acquiring the cameras, whether it is with IT software or anything like that. And so those costs then will probably go down to the parents and, you know, they're just shifting the costs to families who are already struggling to probably pay for child care. So I think those are some of the things that we think about when we are looking at this legislation. I think the other thing that we take into consideration is in the bill, it talks about like data points and child care, not child care, but counties keeping record of the data points. And I know the sub bill earlier kind of clarified what data points are, which are photographs. I think there is no clarification on the county what our responsibility is for that and taking pictures of children. I would strongly be against taking pictures of children and holding that information. I think, as someone said earlier, it gets in the way of privacy. And so I think when we have these unfunded mandates, providers have to look at the cost that they are incurring, but also how does that impact the families that they're trying to serve and provide services for?

Thank you for the question. Through the chair to Representative Click. So as it relates to fraud, I cannot say that there has been or hasn't been any fraud. We know that, for instance, that there have been overpayments to providers in Franklin County, but there has not been any case sent to our Job and Family Services or to the prosecutor's office that has been investigated where we had to, or where the prosecutor's office had to look into. And prosecutor Faber spoke to that last week. We know, as the dispatch reported, that there have been a number of, I think, six child care centers in Franklin County, and I can only speak for Franklin County, that were reported for overpayments. And DCY has made those child care centers aware of the overpayments, what needed to be paid back, as well as amendments to what they originally said was owed to what finally came out that was actually owed. So for the Board of Commissioners, there has not been anything that has come to our offices that's alleged fraud. There have been overpayments that have been made, and DCY has looked into that. To your point about fraud in general, I think we are 100% aligned on stopping any kind of fraud that there is, whether it was for SNAP benefits, as I spoke to earlier, whether it's American Rescue Plan dollars that the Franklin County Prosecutor's Office has went after to recover. But I think when we look at job and family services, our agency, we have a proven record of working with our state agencies to stop any fraud. You might not have been here when I talked in my testimony about anything that we have deemed to be questionable as far as it relates to in-home centers that is under our purview for job and family services. we have referred all of that to DCY, and then they take the investigation from there. And we continue to work really closely, have a really good relationship with those at DCY.

Thank you for the question. Through the Chair White to Representative Click, From my understanding talking to my W County administrator that over job and family services Specifically DCY has not used that phrase that there has been fraud related to any child care centers in Franklin County There has been comments that ended up showing up in the dispatch that there have been overpayments, but there has not been a list of any child care centers provided to Franklin County that is alleged to have or be suspected a fraud.

Absolutely. Thank you for the question through Chair White to the representative. I think there is a number of issues, not just in this bill, we would oppose 647 as well, that would need to change video surveillance. I think that if there is going to be a requirement for that, I think there should be an appropriation so child care centers don't have to bear the burden. And I would also lean on the expertise of child care providers who are dealing with attendance and attendance records every day for the changes that need to be made there. I think there's also a change as it relates to, well, I would say 647, but also 649, as it relates to children whose families need authorization, or maybe what we consider like a dual authorization for families that work non-traditional hours and removing that authorization from county JFS to DCY and making it harder for families who might need multiple child care providers to care for their children because they might have work, school, or I use, for instance, a family that might work or a parent that might work at Honda and has mandatory time or a mandatory shift that they have to take for overtime, and they would need care on the weekends, I think that will be a problem for some families. So I think there are a couple of things that should be changed that we can talk about that would probably move me from a, or move us from a no to interested party. But it's not just, it wouldn't just be the video and surveillance.

Thank you, through the chair to the representative. I am open absolutely with my government affairs director as well as some of our child care providers have an opportunity will welcome an opportunity to talk to the sponsors of the bill for both 647 as well as 649 to talk about the changes that we would like to see, how county JFS would be held responsible, how we make determinations, how we can support our child care providers, protecting families, as well as making sure that obviously there's accountability if there is suspected fraud. But I also would say to that, that when we have a conversation about the changes, it is important to think about at the end of the day, we already have a child care system in place that detects, has a reporting structure for suspected fraud, for investigations. And we know in Franklin County or in the state of Ohio that fraud is not widespread. We have a system that has already, that works, that holds those accountable. And so I caution, you know, having bills that really are in search of problems that don't exist, or that we're trying to put structures in place when we already have a system that works, that works really well. We're one of the best states in the country as it relates to reporting, investigation, and holding those accountable without trying to create more bureaucracy or making our child care centers take on more expenses and rent tape that ultimately doesn't do anything to help our families have more access.

Okay, and Rep. Brewer, you'll have the last question for this witness. Thank you, Madam Chair. Thank you for your testimony. and as we talk about the emphasis of this bill, you say we already have things in place. And as we talk about talk to the sponsors and everything else, wouldn't a more general conversation be an overall look at the whole childcare system, attendance versus enrollment, tap backs versus what you already have in place, how it can be there? And I know you said this seems like a bill looking for a problem, a solution. So should we maybe roll this conversation

Madam Chair. Thank you. Through the chair to Rep Brewer, what I would say is we should be having a conversation about child care in general and how we are supporting families to make sure that they have access to high quality, affordable child care. We should be having conversations about how do we make sure that providers can keep their doors open and expand access to families, as well as making sure that we pay teachers a living wage, we can have a conversation. I've been, prior to me being a county commissioner, was here in the legislature working on child care, working on access, working on eligibility, and we really have not moved the needle. So I think we should be asking questions about how do we make sure that more families have access to high-quality, affordable child care? How do we support our providers? Who are the workforce behind the workforce? This isn't a fraud issue. This isn't an education issue. This is an economic infrastructure issue. We know that at the end of the day, our economy would crumble if we had child care providers continue to close We have child care deserts We know that on average Ohio ranks in the bottom of the list as it relates to eligibility as it relates to supporting three- and four-year-olds, as far as them being kindergarten ready. We can have a robust conversation, which we should be having at the legislative level, as well as the local level on how we can partner together and making sure that we are supporting families and providers and teachers. So that is a conversation that I absolutely would welcome. As I said earlier to Representative Click, if there is fraud that happens, we have structures in place to investigate that and report that. But I think the bigger conversation is, how do we make sure that more families have access and providers are supported?

Thank you for having me.

Hello, everyone. Chairperson White, Vice Chair Savo, and Ranking Member-led members of the committee. My name is Marquita McClendon. I am a child care owner of over 20 years operating multiple programs in the Cincinnati and Hamilton County area. I am also an early childhood educator and a taxpayer who has dedicated half my life in building and sustaining child care in my community. I want to speak specifically to the recent amendments to House Bill 649. While I understand the intent to address accountability, the changes being proposed are still not realistic for how child care actually operates on the ground. First, regarding attendance backdating. The proposal limit of seven days is not aligned with the current system right now. Through KinderConnect, providers can back swipe for three weeks to correct, I'm sorry, four weeks to correct attendance. That is the reality of how the system functions today. And counties are processing applications in a timely manner, then a four-week window to 30-day window for corrections is reasonable and necessary. Anything less will result in payment errors, not fraud, but system-driven mistakes that providers will make and be penalized for. Second, I want to address the shift to biometric data collection every six months. This is not realistic when you're dealing with children, especially infants and toddlers. A child infancy to three months, six months to 12 months, and 18 months can look entirely different. Their facial features change rapidly, their hair changes, their weight changes. As a mother of all girls, I can tell you, simply changing a hairstyle can make a child look completely different. If I pull my daughter's hair back, straight, she could be mistaken for a child, a different child completely. So now we are relying on data points to verify identity, but what happens when a child wants it still? The system glitches, the image doesn't match due to normal development. That is not fraud. That is a system error waiting to happen. Thirdly, let's talk about absent days. When the Once they changed the authorization hours from full time to part time, 25 hours to 33 hours, the absent day structure was never updated to match. Right now, providers receive 20 absent days biannually. 52 weeks in a year, 40 absent days yearly equals .8 average a week. That's not even one. One absent day only covers eight hours, while many children are approved for a 10 hour care day schedule. That means providers are forced to use more absent days than allotted just to cover what should be a standard day. And one equals 10 hours, then one absent day should also equal 10 hours. Next is families relying on a second approved provider for stability. Life happens, parents work multiple jobs, have changing schedules, or faces emergencies. There are also programs that are not open during traditional hours six to six. So if the second provider gives them a backup option so they continue working without interruption. If that second provider is removed, parents will lose flexibility, children will experience more disruptions in care, providers will lose enrollment stability, and ultimately families will fall out of the workforce. Finally, childcare providers are already operating under strict oversight from DCY, adding more rigorous systems, more tracking, and more administrative burden is not solving the issue. The real issue is stability. We have providers right now who still have not got paid. I personally have a program that has not got paid for last week. This is not fraud. This is a system that is not functioning properly. So the concern is not just policy, it's capacity. Do we even have the manpower to infrastructure and the accuracy in place to support the bill that we're asking for? Because right now, it seems not realistic. It seems like pressure is being placed on a system that is already struggling. If enrollment over attendance base were implemented and followed as intended, we would have stability, less discrepancy, and fewer of the issues that this bill is trying to solve. In closing, I ask this committee consider the approach to oppose this bill. The solution is not restrictions and more systems, it's alignment, accuracy and investment in a stable care economy. Thank you so much for your time and I'll be more than happy to answer any questions.

Thank you, Madam Chair, thank you for your testimony. thank you for your service as well. It kind of goes back to the last question that Jas asked once before to the commissioner. As she talked about expanding childcare, how we should be talking about it. Do you think with the passage of these bills and the way they're written now, even with the amendments that we talk about, do you think this would encourage parents to now seek out childcare? Or will this hurt not just parents, but also childcare center owners as well as some of these implementations And so will we be losing childcare or will be gaining childcare Thank you very much Madam Chair Thank you so much for that question Representative Brewer

Rep. Brewer, did you have another question? Okay, let me just clarify a few things if I may, Ms. Clinton. So the amendment allows for the presumptive eligibility back tapping, so that didn't take that away. It allows for in those circumstances.

Just so you're aware, both bills. So we're not taking that away if it takes 30 days or if it's beyond 30 days with the JFS, just to clarify that. But the other thing I wondered is, why did you not get paid? When you find out, you let me know.

Thank you. I'm reformulating because both questions kind of act mine. But thank you. Thank you through the chair. Thank you for your testimony today. So one thing that I think I want to kind of go back through is, you know, I know that pictures and things have been removed from the bill, and we've talked about some of the amendments that have been made. So I kind of like just hearing this from most folks, right? Although we know that fraud has not necessarily been as widespread as some of the disinformation that we've heard, But in your professional opinion, if this bill was to do something that was actually effective, that would not have these negative implications to you all as child care providers and owners and also to parents, is there something where it could be of value to your work to prevent this level of fraud?

I'll just conclude with this question then. Okay. So my understanding, which might be incorrect, but if we're paying on enrollment, that means no matter whether you're there or not, you will be paid. Whether the child's there or not, you will be paid. So how does switching to a system that has no attendance help reduce fraud rather than creating more opportunity for fraud if it's pay on enrollment and there's not the attendance requirements? Could you help me figure that out?

Thank you very much for your testimony today. Thank you, Al.

Good afternoon, everyone. Thank you for taking my testimony. Chair White, Vice Chair Salvo, Ranking Member Lett, and members of the Ohio House Children and Human Services Committee. Thank you for the opportunity to provide opponent testimony on behalf of the CEO Project, which represents over 300 small business childcare providers in Ohio. My name is Teres Thompson, and I am a childcare provider with more than 30 years of experience in the childhood education in Franklin County. I'm also one of your smallest programs because I am a type B. I would like to start by thanking representatives Williams for his willingness to meet with providers and to hear our concerns. We were pleased to see the changes in language regarding the live camera feeds and eliminating the immediate suspension of funding during an investigation. These were thought for amendments and they did not go unnoticed. Our biggest remaining concern is with the facial recognition of children. I have provided you today with a signed letter from 772 parents and family members. That letter also incorporates a map of where those signatures are at, which covers 91 of the 99 districts in Ohio. Every parent I have spoken to about this is frankly outraged at the idea. My hope is that by streamlining the investigatory and prosecution process for referring when these possible fraud situations do get flagged, that they will naturally clean this up. Because of this, this was because if this was the law, but the department was not referring things out, then that is not a broken law so much as it's a broken process. If existing law being enforced would take care of fraudsters, then I ask that we give it a chance before we add in language and spend money to create a system of facial recognition for children. House Bill 649, the sub bill, has a reporting aspect, so you could always come back as a legislator and make additional changes if you feel it's not working to better deter and address situations of fraud. You could also increase penalties for those who commit the fraud. I would like to detail some issues that remain in the event that this committee would entertain additional changes. First, while we have no issue with the portion of the bill allowing for the inspector general to conduct the investigation, we do point out that giving jurisdiction to the attorney general carries with it a disconnect to local control. We believe that the process in place is effective and prefer to keep local control in the hands of the local prosecutor. Second, we are concerned with the due process, an accusation of fraud could come with a disgruntled employee, a parent, or random person in the community. Sorry about that. In order to safeguard against this, we would like to see peer review language be included in this bill so that our businesses can have appropriate levels of due process in any case that will result in our businesses losing their step up to quality rating or that would result in their closure. As part of the last state operating budget process, the Ohio House agreed on peer review language and we would like to see that language inserted into this bill. If we are going to take the time to address something in the childcare industry, we believe it would benefit everyone if we added in comprehensive elements that help business owners in the industry invest with confidence at a time when families in Ohio need more options. Again, this bill has been improved upon and we are hopeful that these changes will be part of any additional amendment considerations. I thank the committee members for your time and would be happy to answer any questions.

Thank you, Chairman White, Vice Chair Salvo, Ranking Member Lett, and members of the committee. Again, I'm Karen Lampe, owner and operator of CWCC Inc. out of the Miami Valleys of Ohio, and representing today the Ohio Association of Child Care Providers. We appreciate the sponsor, Representative Williams, for improvements that he's made to the amended version of the bill, particularly the flexibility added around the use of absent days to include calamity days. However, there are several remaining provisions that raise significant concerns. Privacy concerns regarding mandatory image collection. The amendment requires that providers collect data points of children. In practice, these are images, they're pictures of children. Of each child upon entry and exit each day. While the language differentiates data points from photos, families will not perceive a meaningful difference. An image of a child is still an image collected and stored by the state. This is particularly concerning for children in foster care, kinship arrangements, domestic violence situations, or custody disputes, children for whom protecting the identity and location is essential for safety. There are practical and operational challenges. This bill has language that is incredibly complex, overly complicated, and administratively difficult. Young children do not reliably sit still to face a camera, which will result in blurry or unusable images. The tap tablets, as I mentioned before, are often bolted or mounted at entrances, requiring parents to lift children into position for photos. Capturing that is going to add time and create bottlenecks during busy transitions that are stressful periods already for families for young children and for providers This could increase safety risk during those crowded drop-off and pick-up times. And the current system of parent photo identification at that time of care is already sufficient in doing the job that we need done in Ohio. There is also restrictive and burdensome changes to the backtap system, again, being overly complicated and complex. This amendment would eliminate the process except for under limited DCY approval circumstances, such as outages or national disasters. But as written, providers would not be reimbursed if apparently simply misses a backtap. This means that a provider payment could be denied for provider care that was actually given to the child. This is an unintentional financial risk in an already very fragile system. The sub-bill as written gives broad departmental authority without a lot of clear guidance. and we respectfully urge the committee to reconsider or revise the amendments to remove the language requiring any image, photo identification, data point collection of a child. Preserve the workable, clearly defined back tap process that recognizes real world provider and family needs. 30 days is necessary in order to do that. That's the reality of being a working parent of young children. There's just logistical challenges that have to be met, and we want to make sure that providers are paid for services that they've provided. Please limit the administrative burdens that do not improve child safety and protect the privacy and security of Ohio's children and families. Ohio's early childhood system must be both accountable and practical. We look forward to working with policymakers to ensure that House Bill 649 supports safety, stability, sustainability for the children and families that we serve. Thank you. I'm available for any questions you may have.

Vice Chair Salvo. Thank you, Chair, and thank you again for your testimony. Thank you. When you earlier described the process, you said that ratio is like one tablet to 50?

Is that not something that we could explore? Because it sounds like the tapping is the problem, but when you're describing that scenario, it makes you go, of course there's a line every morning when this is happening. Is that something that was proposed in rulemaking? Is that a potential to change?

Follow-up? Yeah. Are there any other questions for this witness?

Chair White Vice Chair Salvo Ranking Member Lett and members of the committee thank you again for the opportunity to testify on House Bill 649 Again I Leslie Doria and I the Vice President of Child Care for the YMCA of Greater Toledo and I am here on behalf of the Ohio Alliance of YMCAs The Ohio Ys are grateful to the bill's sponsors and this committee for amendments that already have been made to improve House Bill 649, including allowing more flexibility for absence days. However, we would like to share new concerns regarding the bill's requirement to use data point identification and back TAPs. These changes, while intended to create accountability and transparency, would cause serious unintended harm. First, amended House Bill 649 requires children to be identified in the TAPs system instead of the parents. For purposes of recording and verifying child care center attendance, the amended bill requires child care centers to use DCY-provided tablets to record data point identification of each child in publicly funded care at the time of care. The bill also requires these data points to be updated every six months. First, while the bill no longer captures pictures or videos, it does require data points of children's faces to be captured and be available to DCY. Facial data point capture is very similar to photo collection, and thus the collection and sharing of these data point images still raises serious privacy concerns. concerns. Parents often do not want their children captured in pictures and will struggle to understand the difference between a photo and a facial data point. Capturing any images of their children, whether using data points or photos, will cause families great unease and may deter them from seeking care for their children. Second, there are practical concerns, as some of my other fellow Although colleagues have said in implementing these requirements, often young children do not hold still to have their picture taken, and the same would apply for facial data point collection. If the child is moving or not facing the camera, the data points could not be used to verify attendance as intended. Third, requiring families to update data points of their children every six months is burdensome to those families, and the Ys already struggle to get families to complete paperwork and taps in and out each day. Asking those same families to ensure their children's facial data points are updated with DCY every six months is just not feasible. Children would end up with outdated facial data point information, thus preventing their attendance to be verified. The current system of parent photo identification at the time of care is sufficient to prove a child's attendance. Second, the bill's new provisions severely restrict the ability for YMCAs to use back taps and would prevent many families from receiving care. In the previous substitute bill for House Bill 649, the bill proposed allowing back taps when DCY approved them. We raised a question in our last testimony about whether that language meant the department would have to approve using back taps in each instance or could adopt a general rule. In the amended version of House Bill 649, the bill would require DCY to approve each instance and only when the approval is necessary to accommodate a system outage or a natural disaster. Thus, backtaps would not be allowed at all without extenuating circumstances, and approval would be required in each instance. In those extenuating circumstances only if DCY approves a Y could backtap and use the day window laid out in the bill This provision would completely disallow back tapping simply because a family missed a tap. Thus Ys would never be reimbursed for care provided to a family that made maybe one mistake. YMCAs would be forced to discontinue care for a family if that family missed any single tap. This change to the bill would prevent thousands of families and children from receiving childcare. In conclusion, Ohio's childcare system depends on stability, clarity, and fairness. We respectfully urge the committee to reconsider or revise the amendment to remove language around facial data points for children and remove all language disallowing back taps only in extenuating circumstance and with DCY approval for each back tap. Thank you for your time, and I'm happy to answer any questions that you may have.

Ranking Member Lett, you had a question? Thank you, Chairwoman. Thank you so much for your testimony. I am a learner observer, so it takes me a second to think through my questions. But one of the things that I've really struggled with with both of these bills is the whole TAP system to begin with. We have students going to our public universities that are receiving scholarships that are public money. They show up for class or they don't, regardless the university or college gets paid. So I struggle to see how the workforce that supports our workforce should have to live under this burden to begin with when there's no other place in society where we can see this paying out. So that is my problem, one, with the entire system in and of itself. But secondly, I am deeply concerned that making the TAP system even more burdensome will actually decrease child care capacity. You mentioned in earlier testimony that you already have a full-time individual dedicated to verifying with parents and correcting any of these errors. You don't increase capacity with this. there's a possibility that you would actually decrease and then have to hire an additional individual. So I guess my overall question is, do you believe that that decrease is imminent? Do you think that this bill and potentially 647 as well would actually decrease our childcare capacity? And are you worried about that for the why? Thank you.

So I do worry that we will see fewer and fewer providers that will serve publicly funded children. You know, for my locations of our 22 sites, we're about 60% private pay and 40% publicly funded. So, you know, if the continued burdensome, you know, if we continue to have more and more burden in this system, we may have to consider certain programs not serving publicly funded students just because of the sheer fact of the amount of work that would be put into that, or we would have to really create policies for our families that would almost deter them from even enrolling with us, which we've already done. We've already done that. We've already implemented new policies around public funds at all of my facilities, around attendance requirements, around apps. day usage. You know, I'm at a point here where some of our families are already running out of absence days due to this lovely winter we had. And, you know, I'm at a point where we're going to have to start charging families. That's nothing we've ever done before. You know, so I do worry that those families who need us the most are now going to maybe have to carry that weight of that. And are they even going to be able to afford something like that? So yes, I do worry that there will be fewer and fewer providers that serve publicly funded students. Thank you. No follow-up.

Sure. Thank you. And Representative White, I think we were living in a little bit different time. You know, our requirements currently in the new full-time, part-time, hourly categories has greatly changed. And as a YMCA, we serve a large group of school-agers in our programs. So prior to this change, seven hours got us to a part-time week. Now at 10 hours, that is challenging for a school-ager. They would almost have to come every day before school and after school. And even if they came one morning, we wouldn't be able to use an absence day in the afternoon either. So we are somewhat using more absence days for families that are not attending to try to get to that 10-hour mark. So that is part of it. We weren facing that pre It was a different category 25 hours to be full full was different especially in our early childhood you know programs Getting somebody to 33 hours a week that pretty much a family has to be there every day for, you know, their full eight hours. They really can't miss a day. So that is one thing that we're still struggling with and has created a little bit more burden and why we had to implement stricter policies. Thank you for the clarification. And so

Chair, I don't believe that that was the rate that we were receiving at that timeline. School age was lower. or that in referring to school-age care.

Thank you, Chairman White. Again, Karen Lampe. So the school age rates are set up a little bit differently than what our infant through preschool are. I'd have to go back to look at the actual percentage to see if it's 75%. But it based upon what we charge our private pay parents which for private pay regardless of how many hours they come they pay the full amount In my case for the entire month regardless of their attendance they pay the full amount for the month For publicly funded, we have to patch together this patchwork of how many hours did they come, how many absent days do they have, can we use an absent day, does the absent day get us to the number of hours that we need? But regardless in any of that, the cost for our insurance, the cost for our electricity, the cost for gas, the cost for your equipment for your food, for your teachers, doesn't change. So what has changed is that the state used to pay us our rate based upon the child attending 25 hours, and then we swung the pendulum all the way to the extreme to 33 hours. it's too far. I understand if the state needs to make tweaks to things, we are swinging the pendulum too far. And that's the difference between where we were pre-COVID and where we are today. We've swung the pendulum too far. Okay. Thank you for clarifying. And I will get

So, Chairman White, I will have to get back to you with exact details. But while we do have what seems like a large number of absent days, structurally, how we create our system together does not make it necessarily to where it is more beneficial than what other states are. And so it really about the patchwork system that we create in Ohio that makes it difficult So we get back to you with that exact data though Yep thanks very much And I get additional information for the committee regarding enrollment versus attendance of other states I know some other states have started restricting eligibility because of the finances related to that, but we need facts in front of us as we consider this.