Overview of Child Care Health Consultation - Healthy Child Care

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					Overview of Child Care
 Health Consultation

     Name of Presenter
                              Overview of Child Care Health Consultation




                          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
        www.healthychildcare.org
                              Overview of Child Care Health Consultation




  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.

          www.healthychildcare.org
                            Overview of Child Care Health Consultation



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


        www.healthychildcare.org
                             Overview of Child Care Health Consultation




        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


         www.healthychildcare.org
                           Overview of Child Care Health Consultation




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




       www.healthychildcare.org
                            Overview of Child Care Health Consultation




  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


        www.healthychildcare.org
                             Overview of Child Care Health Consultation




  What Should a CCHC Know?
• Immunizations
• Injury prevention
• Oral health
• Nutrition and physical activity
• Inclusion of children with special needs
• Staff health
• Environmental health

         www.healthychildcare.org
                             Overview of Child Care Health Consultation




         Specialty Consultation
• Mental health
  (Early Childhood Mental Health Consultant)


• Nutrition & physical activity
  (Early Childhood Nutrition Consultant)


• Oral health
  (Early Childhood Oral Health Consultant)



         www.healthychildcare.org
                            Overview of Child Care Health Consultation




           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
        www.healthychildcare.org
                            Overview of Child Care Health Consultation




           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



        www.healthychildcare.org
                                                                   Overview of Child Care Health Consultation


Effect of Child Care Health Consultation
on Health Issues and Policies in 5 States
                                                                         NTI
                                                                Evaluation Summary
                                                    Means of Issues and Policies by Time Period
                                                                        n=23


                   3
                                                                                          2.63                             2.58
                                                    2.51
                                                                        2.44       2.40
                  2.5                                                                                               2.38
                                             2.28                2.31

                                                                                                           2.09

                   2                                                                                1.87
 Response Value




                                 1.51
                  1.5

                          1.02
                   1



                  0.5



                   0
                        Health Policies   Sanitation Issues   Safe/Active Play    Em ergency     Nutrition Issues   SID Issues
                                                                  Issues         Preparedness
                                                                                    Issues


                        www.healthychildcare.org                                                                                  12
                        Overview of Child Care Health Consultation


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




    www.healthychildcare.org                                         13
                            Overview of Child Care Health Consultation


   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.

        www.healthychildcare.org                                         14
                               Overview of Child Care Health Consultation




                Impact of CCHCs
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

           www.healthychildcare.org
                              Overview of Child Care Health Consultation




    Child Care Health Advocates
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

          www.healthychildcare.org
                            Overview of Child Care Health Consultation




  Child Care Health Advocates
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.


        www.healthychildcare.org
                               Overview of Child Care Health Consultation




                Finding a CCHC
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

          www.healthychildcare.org
                            Overview of Child Care Health Consultation




        State CCHC Initiatives
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



        www.healthychildcare.org
                           Overview of Child Care Health Consultation


            Facilitators to
     Implementing 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


       www.healthychildcare.org
                             Overview of Child Care Health Consultation




                        Barriers
• 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)

         www.healthychildcare.org
                    Overview of Child Care Health Consultation




Pediatricians as CCHCs




www.healthychildcare.org
                             Overview of Child Care Health Consultation




       Pediatricians as CCHCs
What pediatricians have             What programs can
to offer:                           offer:
• Expertise & knowledge in          • An opportunity for
  child health issues                 community-pediatrics-in-
• Resources                           action
• Exchange of advice                • Medical referrals
  without regulation                • Children without medical
                                      homes
                                    • Families seeking advice &
                                      assistance

         www.healthychildcare.org
                             Overview of Child Care Health Consultation



Tips for Working With Child Care Programs

1. Establish practical guidelines
   •   How should the program contact you?

2. Be familiar with licensing rules & regulations
3. Visit the program to meet staff. Remember that
   you are engaging with a “different culture”
4. Demonstrate an appreciation for the program’s
   challenges & strengths
5. Avoid becoming the “child
   care police”
         www.healthychildcare.org
                            Overview of Child Care Health Consultation



Tips for Working With Child Care Programs

6. Create a trusting relationship
7. Listen carefully, ask questions, clarify
8. Recognize & respect each other’s knowledge,
   experience, and feelings
9. Show empathy and understanding of a
   program’s constraints
10. Understand that illnesses in child care may be
    treated differently than in the child’s home
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                             Overview of Child Care Health Consultation



Tips for Working With Child Care Programs
11. Make recommendations that…
   •   Build on positive things already being done
   •   Are cost-effective
   •   Are easily implemented
12. Prioritize your concerns; avoid overwhelming
13. Promote, don’t interfere, with existing
    relationships between families & their medical
    homes
14. Give clear & simple advice
15. Pursue a long-term consulting relationship
         www.healthychildcare.org
                            Overview of Child Care Health Consultation




   Other Issues to Remember:
• Consent and confidentiality

• Liability
  – To limit liability, follow the most current AAP
    recommendations
  – Refer to your state licensing regulations for
    consultation guidelines


        www.healthychildcare.org
                              Overview of Child Care Health Consultation




  Don’t Have Time to Be a CCHC?
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

          www.healthychildcare.org
                    Overview of Child Care Health Consultation




            Resources




www.healthychildcare.org
                             Overview of Child Care Health Consultation




                AAP Standards
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

         www.healthychildcare.org
                            Overview of Child Care Health Consultation




               AAP Standards
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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                           Overview of Child Care Health Consultation




              AAP Standards
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:
                     – Allergies       – Diabetes
                     – Asthma          – Heart conditions & defects
                     – Autism          – Seizures
                 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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                            Overview of Child Care Health Consultation




                Model Policies
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
        www.healthychildcare.org
                            Overview of Child Care Health Consultation




           Pediatrician’s Role
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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                            Overview of Child Care Health Consultation




     Licensing and Regulations
• 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 info@nrckids.org to be added to the NRC
     listserv

        www.healthychildcare.org
                            Overview of Child Care Health Consultation




                    Training
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
        www.healthychildcare.org
                            Overview of Child Care Health Consultation




                 NTI Flowchart
               NTI Train-the-Trainer Program:
       Develop expert-reviewed, rigorous curriculum
     Evaluate curriculum materials and training methods
  Present training through distance learning and on-site visit
                       NTI Trainers:
            Graduates of NTI’s training program
 Develop state/regional curriculum based on NTI curriculum
                  Train at least 10 CCHCs

             Child Care Health Consultants:
                   Trained by NTI Trainers
Provide consultation and other services to child care providers

        www.healthychildcare.org
                    Overview of Child Care Health Consultation


     Building Better Child Care
    Through 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

www.healthychildcare.org
                           Overview of Child Care Health Consultation




 Become an NTI CCHC Trainer
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: nti@unc.edu
           Web site: http://nti.unc.edu


       www.healthychildcare.org
                                 Overview of Child Care Health Consultation




         www.healthychildcare.org
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:           childcare@aap.org
Web site:         www.healthychildcare.org
Phone:            888/227-5409

             www.healthychildcare.org
                                           Overview of Child Care Health Consultation




                               References
•   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

               www.healthychildcare.org
                    Overview of Child Care Health Consultation




           Questions?




www.healthychildcare.org

				
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