Overview of child care health consultation
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Overview of Child Care Health Consultation. Name of Presenter. Outline. Role of child care health consultants Who are they? What are the benefits? Where do I find a child care health consultant? Pediatricians as child care health consultants

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Outline

  • Role of child care health consultants

    • Who are they?

    • What are the benefits?

    • Where do I find a child care health consultant?

  • Pediatricians as child care health consultants

    • What can pediatricians offer child care programs?

    • What can child care programs offer pediatricians?

    • How can pediatricians build a relationship with child care programs?

  • Resources

    • Publications

    • Licensing & Regulations

    • Training


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Health & Safety in Child Care

  • Healthy and safety topics can have a broad range of issues from simple to complex

    • Minor injuries

    • Infectious diseases

    • Health & safety policies

    • Care plans for children with chronic health conditions

  • Child care health consultants can help ensure provision of safe and healthy environments for children.


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What is a Child Care Health Consultant?

  • A child care health consultant (CCHC) is a health care professional who…

    • has interest in & experience with children,

    • has knowledge of resources & regulations, and

    • is comfortable linking health resources with facilities that provide primarily education & social services


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Who Can Be a CCHC?

  • Nurses, nurse practitioners, physician assistants, physicians, health educators, nutritionists, dental hygienists, sanitarians, & medical social workers

  • Must have:

    • Knowledge & experience in health & safety practices in child care

    • Specialized training


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State Regulations

  • [If presenting in a particular state, provide the state’s regulations here]


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What Should a CCHC Know?

  • National health & safety standards

  • Licensing requirements

  • Child care day-to-day operations

  • Disease reporting requirements

  • Reporting requirements for child abuse & neglect

  • Community and mental health resources


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What Should a CCHC Know?

Immunizations

Injury prevention

Oral health

Nutrition and physical activity

Inclusion of children with special needs

Staff health

Environmental health


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Specialty Consultation

  • Mental health (Early Childhood Mental Health Consultant)

  • Nutrition & physical activity(Early Childhood Nutrition Consultant)

  • Oral health(Early Childhood Oral Health Consultant)


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Benefits of CCHCs

  • CCHCs can help improve health & safety by:

  • Consulting and teaching child care providers & parents

  • Assessing needs

  • Providing on-site, phone, & e-mail TA

  • Providing referrals to community services

  • Developing/updating policies


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Benefits of CCHCs

  • Reviewing health records

  • Helping to manage care of children with special health needs

  • Consulting with a child’s health care professional

  • Assisting with developmental screening

  • Interpreting standards/regulations




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Effect of Child Care Health Consultation on Health Issues and Policies in 5 States

  • CCHCs have a positive impact on child care facility health policies and observable health issues.

  • CCHCs have a positive impact on children’s access to care.

  • Through training, monitoring and follow-up, CCHCs can improve child care providers’ diapering and food handling behaviors.

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Impact of CCHCs and Policies in 5 States

  • 2006 literature review found these positive outcomes:

  • Policy: Positive impact on standard-based health & safety policies

  • Practice: Effective in promoting specific health practices in child care programs

  • Regular Source of Care: Contributes to increased # of children with up-to-date immunizations & regular source of medical care

  • Specialty Consultation: Contributes in specialty areas including mental health, nutrition & physical activity, & oral health

  • Process of Consultation: Collaborative relationship between director and CCHC facilitates effective consultation


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Child Care Health Advocates and Policies in 5 States

  • A child care health advocate (CCHA) can help

  • implement the advice of a CCHC.

  • For centers, the CCHA can be

  • licensed/certified/credentialed as a…

  • Director

  • Lead teacher

  • Associate teacher

  • Health care professional, health educator, or social worker who works at the facility


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Child Care Health Advocates and Policies in 5 States

  • Responsibilities:

  • Policies

  • Day-to-day issues related to health

  • Does not need to perform health & safety tasks,

  • but should be the person to raise health &

  • safety concerns.


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Finding a CCHC and Policies in 5 States

  • Varies state-to-state: CCHCs may be…

  • Employed by public or non-profit agencies

    • State & local health department

      eg, Public health nursing department

  • Available at CCR&R

  • Available through referral at other health institutions

    eg, local AAP chapters; National Training Institute for Child Care Health Consultants

  • Independent

    • Parent of a child enrolled in child care program who is a health care professional capable of performing as a CCHC

    • Local pediatrician, nurse, or other health care professional


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State CCHC Initiatives and Policies in 5 States

  • 2006 report of 54 states & territories found:

  • 27 have established, ongoing initiatives

  • 10 are re-building former initiatives or beginning new ones

  • 12 are no longer active or reduced in capacity

  • 5 had no state-level initiative


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Facilitators to and Policies in 5 StatesImplementing CCHC Programs

Linkages between community agencies and child care programs

Strong commitment to the CCHC program by the lead agency

Ample community health resources

Good communication and personal relationships


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Barriers and Policies in 5 States

  • Lack of funding

  • Lack of available community health & safety resources

  • Lack of systems

  • Child care providers unfamiliar with CCHC or unable/unwilling to participate

  • Geographic barriers (access to resources for rural programs)


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Pediatricians as CCHCs and Policies in 5 States


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What pediatricians have and Policies in 5 States

to offer:

Expertise & knowledge in child health issues

Resources

Exchange of advice without regulation

What programs can

offer:

An opportunity for community-pediatrics-in-action

Medical referrals

Children without medical homes

Families seeking advice & assistance

Pediatricians as CCHCs


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Tips for Working With Child Care Programs and Policies in 5 States

  • Establish practical guidelines

    • How should the program contact you?

  • Be familiar with licensing rules & regulations

  • Visit the program to meet staff. Remember that you are engaging with a “different culture”

  • Demonstrate an appreciation for the program’s challenges & strengths

  • Avoid becoming the “child care police”


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Tips for Working With Child Care Programs and Policies in 5 States

  • Create a trusting relationship

  • Listen carefully, ask questions, clarify

  • Recognize & respect each other’s knowledge, experience, and feelings

  • Show empathy and understanding of a program’s constraints

  • Understand that illnesses in child care may be treated differently than in the child’s home


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Tips for Working With Child Care Programs and Policies in 5 States

  • Make recommendations that…

    • Build on positive things already being done

    • Are cost-effective

    • Are easily implemented

  • Prioritize your concerns; avoid overwhelming

  • Promote, don’t interfere, with existing relationships between families & their medical homes

  • Give clear & simple advice

  • Pursue a long-term consulting relationship


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Other Issues to Remember: and Policies in 5 States

  • Consent and confidentiality

  • Liability

    • To limit liability, follow the most current AAP recommendations

    • Refer to your state licensing regulations for consultation guidelines


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Don’t Have Time to Be a CCHC? and Policies in 5 States

  • Pediatricians can still help advocate for CCHCs

  • Promote the use of CCHCs

  • Educate other pediatricians and health care professionals about CCHCs

    • CCHCs can be the liaison between the pediatrician and child care program

  • Help connect CCHCs with local professional chapters

    • eg, AAP, NAPNAP

  • Assist with training CCHCs

  • Provide resources to CCHCs


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Resources and Policies in 5 States


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AAP Standards and Policies in 5 States

Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, 2nd Ed

  • Primary reference for health & safety in child care!

  • 707 standards & recommendations

  • Developed by AAP/APHA

  • Includes rationale for why standards are important; based on evidence when possible

  • Full text is available at: http://nrckids.org/CFOC/index.html

  • Print copies from AAP, APHA, NAEYC:

  • http://tinyurl.aap.org/pub38873


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AAP Standards and Policies in 5 States

Managing Infectious Diseases in Child Care and Schools:A Quick Reference Guide, 2nd Ed

  • Includes more than 50 quick reference fact sheets on common diseases and symptoms featuring:

  • Easy-to-understand explanations

  • Strategies for limiting spread of infection

  • Exclusion and readmission criteria

  • Guidance on which situations require immediate medical attention

  • http://tinyurl.aap.org/pub52359


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AAP Standards and Policies in 5 States

Managing Chronic Health Needs in Child Care and Schools: Quick Reference Guide

  • Includes more than 35 quick-access fact sheets that describes specific conditions, like:

  • Also includes:

    • Care plans

    • Emergency planning recommendations

    • Ready-to-use sample letters & forms

    • Medication administration issues

  • http://tinyurl.aap.org/pub92742


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Model Policies and Policies in 5 States

Model Child Care Health Policies

  • Over 60 Sample policies – examples:

    • Admissions policy

    • Evacuation procedure

    • Daily transportation to & from program

    • Pet policy

    • Food brought from home

  • Also:

    • Health & safety checklist

    • Injury report form

  • Available online at Healthy Child Care Pennsylvania

  • www.ecels-healthychildcarepa.org

  • Available in print from NAEYC


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Pediatrician’s Role and Policies in 5 States

The Pediatrician’s Role in Promoting Health and Safety in Child Care

  • Resource guide designed to help pediatricians become more involved in child care issues

  • Provides suggestions on how to be involved at 3 different levels:

    • Level 1: Providing Guidance to Families on Child Care Issues

    • Level 2: Providing Health Consultation to Child Care Programs

    • Level 3: Advocating for Quality Child Care

  • http://tinyurl.aap.org/pub38947


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Licensing and Regulations and Policies in 5 States

  • Individual states’ child care licensure regulations: http://nrckids.org/STATES/states.htm

  • Sign up for the National Resource Center for the Health and Safety in Child Care and Early Education (NRC) listserv

    • Encourages health care professionals & other key leaders to share ideas/resources with each other

    • E-mail [email protected] to be added to the NRC listserv


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Training and Policies in 5 States

  • National Training Institute for Child Care

  • Health Consultants (NTI)

  • Goal: To enhance the quality of out-of-home child care through CCHC

  • Trains trainers of CCHCs

  • 15 modules on child care related topics

  • Format: pre-training work, 4 days on-site followed by 13 weeks of distance learning


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NTI Flowchart and Policies in 5 States


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Building Better Child Care and Policies in 5 StatesThrough Health Consultation

  • Video produced by NTI

  • Introduces the role of the CCHC

  • Hear the experiences of child care center directors, health consultants, and consultant trainers

  • http://nti.unc.edu/video


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Become an NTI CCHC Trainer and Policies in 5 States

  • For more information on how to become a CCHC trainer, or how to find a CCHC trainer in your area, contact NTI at:

  • Phone: 919/966-3780

  • E-mail: [email protected]

  • Web site: http://nti.unc.edu


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www.healthychildcare.org and Policies in 5 States

  • For additional resources, visit the Healthy Child Care America Web

  • site (a program of the American Academy of Pediatrics), which

  • includes:

  • Tips for engaging in a health consultation relationship

  • Reducing the Risk of SIDS in Child Care speaker’s kit

  • Medication administration curriculum for use by CCHCs

  • E-News

  • Searchable Resource Library

  • AAP Chapter Child Care Contacts

  • E-Mail: [email protected]

  • Web site: www.healthychildcare.org

  • Phone: 888/227-5409


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References and Policies in 5 States

  • American Academy Of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education. Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, 2nd edition. Elk Grove Village, IL: American Academy of Pediatrics and Washington, DC: American Public Health Association; 2002

  • Farrer J, Alkon A, To K. Child care health consultation programs: barriers and opportunities. Maternal and Child Health Journal. 2007;11(2):111-8

  • Kotch, J. Infectious disease in out of home child care: the impact of child care health consultation. Chapel Hill, NC: National Training Institute for Child Care Health Consultants; 2008

  • National Training Institute for Child Care Health Consultants. How to Choose and Use a Child Care Health Consultant. Available at: www.healthychildcare.org/pdf/HowtoChooseCCHC.pdf

  • Ramler M, Nakatsukasa-Ono W, Loe C, Harris K. The influence of child care health consultants in promoting children’s health and well-being: A report on selected resources. Newton, MA and Oakland, CA: Healthy Child Care Consultant Network Support Center. 2006

  • United States. Maternal and Child Health Bureau. Child care health consultation initiatives: A status report. Newton, MA: Education Development Center, Healthy Child Care Consultant Network Support Center. 2006


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Questions? and Policies in 5 States


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