Minutes April 16 2009 NW by 03tUBH5a


									                   Northwest Child Care Consortium Meeting Minutes
                                    April 16, 2009

Present: Julie Wasilewski, Opportunity Council (CCR&R); Katy Levenhagen, Snohomish
Health District; Nicole DeFrank, Snohomish Health; Ellen Flamiatos, Sea-King Health;
Nancy Mills, Sea-King Health; Caroline Lokkins, Island County Health Department; Judy
Ziels, Whatcom County Health; Linda Albert, Skagit County Health; Dianne Dyer, San
Juan County Health; Yuko Umeda, Jefferson County Health; Mernie Grahm, DEL; Donna
Horn, Skagit Child Care Resource & Referral; Nancy Schiedermayer, Clallam County
Health; Jan Gross

Program Updates:
Jan Gross – cleaning out her office space and has lots of materials that are available for
the taking.

San Juan County – Bridges training has been successful. The proposed new infant
center will NOT open. There is a lice outbreak on San Juan Island.

Snohomish Health District – Two new nurses have joined the program. Megan Whitaker
and Alba Suarez both worked previously in the immunization clinic. There were some
staff reductions in January (the program lost 0.5 FTE health educator, lost the behavior
health specialist position, and reduced hours for the program manager and office
support staff). Snohomish is piloting a health award program called T.E.S.K. (Taking
Extra Steps for Kids) and beginning a formal monthly infant nurse consultation service.

Jefferson County – child care programs are struggling with decreased enrollment.

Island County – child care are also experiencing lower enrollment.

Clallam County – Nancy is now doing the child care consultations for Clallam County.
She works out of the Forks office but is responsible for covering the whole county.

Skagit County CCR&R – Donna Horn is the new program manager in the Skagit office.
Class numbers are down, but the program will soon be offering classes for family,
friends and neighbors.

Skagit County Health – Centers are at maximum capacity for infants. Connections
conference was well-attended. The health department has scheduled 5 furlough days
this year to help ease budget constraints. The lead testing clinic for Head Start was
successful. Approximately 100 kids were tested, and only one child had an elevated
blood lead level.

Seattle-King Health – will have 10 furlough days this year. The future of the program is
unclear, but the proposed plan includes cutting the program back to just 5 nurses and 1
nutritionist (and Lenore’s position is currently grant funded). There has been a lot of
community support. The Behavior Handbook is ready, but we are waiting for
DOH/HCCW to complete the printing. The program hosted an infant/toddler conference,
which was very successful.
DEL – funding is primarily from the federal government, so the majority of DEL is
insulated from the state budget problems. However, there will likely be layoffs at DEL
headquarters in Olympia. There is a new director, Betty Hyde, who was the
superintendent at Bremerton School District.

Opportunity Council- service area includes Whatcom, San Juan and Island counties. The
program is currently in the process of getting accredited. Julie was at the NACCRR
(National Association for Child Care Resource and Referral) meeting in Washington D.C.
Referral calls are down. Bridges trainings are steady.

Whatcom County – is also experiencing some uncertainty about the future of programs
at the health department. At this point, it looks like the child care health program will
continue, but may be folded into the school health program. They are helping to restart
the community team for infant mental health. This community team is hoping to be a
part of the future search process for children with special health care needs. Judy also
gave us an update on Alexis.

Statewide Updates – notes from Teresa and HCCW:
    - New CIS form is available for newly enrolled children in child care settings. Child
       care staff do not have to fill in the new form for children who are already
       enrolled in their program.
    - A FAQ sheet about the new CIS forms were distributed.
    - The bill to make vaccine exemptions more difficult is still on track in the state
       legislature. This bill would require exemptions to be signed by a health care
    - Child Profile update newsletter is posted on the DOH website.
    - Immunization update – pneumococcal will be a required vaccine as of July, 2009.
    - DOH is under a contact- and hiring-freeze. The HCCW contract will continue as
       an interagency agreement.
    - HCCW database updates:
           o There will be a survey of child care health consultants.
           o Please get your data entered for January – March. Reminder to enter
               your data regularly and NOT wait till the end of the month or longer.
    - Teresa will demonstrate the HCCW website at the next meeting. Until then,
       check it out and send comments to Teresa.
    - Question for Teresa: Where is the Behavior Handbook? Is it ready yet?

DEL Health Specialist Role:
   - The six health specialists are training the center licensors on activities that the
      health specialists used to do, like measuring rooms and doing initial inspections.
      Then there will be training for the home licensors.
   - The health specialists are primarily consultants to the licensors, but will also be
      available to consult with the child care provider directly.
   - The licensor will still go on complaint investigations, and will make referrals to
      the health specialists as necessary.
   - There is no criteria/policy for when a licensor needs to call a health specialist.
Question about bleach solutions:
- It is generally recommended to use spray bottles for bleach water in classrooms. If a
program chooses, it is OK to use a bucket of bleach water with the rags stored in the
bucket. Bleach water in a bucket should be changed frequently (at least every 4 hours
and more frequently if the water gets cloudy).
- Snohomish Health District recommends the following bleach concentrations:
    - General purpose (food contact surfaces and toys): ¼ teaspoon of bleach per
        quart of water (1 teaspoon per gallon)
    - Diapering surface and bathroom: 1 tablespoon of bleach per quart of water (1/4
        cup per gallon)
    - MRSA outbreak: 1 tablespoon of bleach per quart of water for surfaces
        contaminated with pus or drainage. Can also use this stronger solution for all
        surfaces at the end of the day.
    - Norovirus outbreak: 1/3 cup of bleach in a gallon of water for surfaces
        contaminated with vomit or stool.
    - Blood spill: 1:10 ratio of bleach:water

Please review the attached document: The Great Bleach Mystery Table, complied by Jeni
Nybo from Tacoma Pierce County Health Department

ERRNIE (Environmental Risk Reduction through Nursing Intervention and Education)
Whatcom County nurses participated in a UW research project designed by Patricia
Butterfield. The project was based in rural communities (second study site is in
Montana). Participating families earned an income of less than 200% of the federal
poverty level. The aim of the study was to improve the health/safety of the home
environment. The study consisted of three observation visits (from a UW researcher)
and four intervention visits from a visiting nurse. Intervention visits included education
and tools for addressing mold/moisture, radon, lead, well water, tobacco, and mercury.
One very interesting part of the study was measuring the cotinine levels in young
children (can be tested in saliva or urine). This was very effective at demonstrating
secondhand smoke exposure. Whatcom would like to continue is part of the study and is
exploring grant opportunities.

Next Meeting: July 23rd, 10:00 – 2:00, Whidbey Island Presbyterian Church,
1148 SE 8th Avenue
Proposed agenda topic: Transitions (with a focus on transitioning children from foster
care to back home) by Lenore Rubin
        Judy will send a reminder email about the next meeting.
        Please “Reply ALL” when responding the email reminder.

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