This is a story about making great-tasting sugar free lemonade from lemons.  About a year and a half ago the legislature passed a bill that eliminated our general funds for licensing (nursing homes, assisted living, hospitals, behavioral health, child care etc.).  In exchange, the Bill included a provision that gave us “exempt” rulemaking authority to collect fees to run our licensing and assurance activities.

We ran diagnostics and estimated what the fees would need to be to satisfy our statutory responsibilities for each of our programs and ran a rule package to set the new fees.  During the comment period our licensed childcare facilities expressed deep concerns about the fees.  One of the root problems was that childcare facilities were on a 3-year licensing cycle and their fees had been nearly completely subsidized by taxpayers (the general fund).  Some licensees were holding $150 licenses that were good for 3 years and that were paid as late as December of ’09.  As a result, we couldn’t convert to a 1-year cycle which would have cut their out of pocket expenses by 2/3.

As an alternative- we used federal funds through our Title V Maternal & Child Health funds to provide an incentive for facilities to improve physical activity and nutrition during the day.  Childcare facilities that elect to participate in our Empower program essentially receive a 50% discount on their fees in exchange for implementing simple and cheap operational changes that improve nutrition and physical activity at childcare facilities.  Well over 99% of facilities have elected to do the Empower program in exchange for the discount.  Only 2 facilities have elected to pay the full fee in the year and a half the program has been operational.  Feedback from facilities and families (especially moms) has been positive.

Now there’s a nationwide buzz about our creative solution to leverage Title V Maternal & Child Health funding to improve physical activity and nutrition for pre-schoolers.  Jeanette Shea has been invited to present the Empower program at the national Childhood Obesity Conference next week.  The planning committee included folks who saw the presentation on Empower at the National Association of Maternal and Child Health Programs last February, and they wanted to make sure folks from all over the country had a chance to see the exciting things happening in Arizona.

But wait- there’s more.  The Institute of Medicine report on Early Childhood Obesity Prevention Policies came out yesterday- and Arizona was recognized as one of the states over the last two years who have improved nutrition and physical activity in preschools.  Those changes were a direct result of our work with Empower.  On the local front, the Arizona Academy of Pediatrics presented their coveted Community Partnership Award to Karen Sell this month to recognize the success of the Empower program.

The recognition is nice, but the best part of all is the response from the child care community and parents.  They’ve embraced Empower and that has changed the way child care is delivered throughout the state.  Now, we’ve started a national dialog on physical activity and nutrition in preschool.  Necessity really is the mother of invention!