overview of child care health consultation name of presenter
TRANSCRIPT
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Overview of Child Care Health Consultation
Name of Presenter
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Overview of Child Care Health ConsultationOverview of Child Care Health Consultation
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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• Health 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
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Effect of Child Care Health Consultation on Health Issues and Policies in 5 States
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• 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.
Effect of Child Care Health Consultation on Health Issues and Policies in 5 States
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Impact of CCHCs2006 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 AdvocatesA child care health advocate (CCHA) can help implement the advice of a CCHC.
For centers, the CCHA can belicensed/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
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 CCHCVaries 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
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 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
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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)
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Pediatricians as CCHCs
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Pediatricians as CCHCsWhat pediatricians haveto offer:
• Expertise & knowledge in child health issues
• Resources• Exchange of advice
without regulation
What programs canoffer:
• An opportunity for community-pediatrics-in-action
• Medical referrals• Children without medical
homes• Families seeking advice &
assistance
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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”
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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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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
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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
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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
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Resources
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• Primary reference for health & safety in child care!
• Developed by AAP/APHA/NRC
• Includes rationale for why standards are important; based on evidence when possible
• Full text is available at: http://www.nrckids.org/CFOC3/index.html
• Print copies from AAP, APHA, NAEYC: http://tinyurl.aap.org/pub38873
Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs, 3rd Ed
AAP Standards
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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
Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 2nd Ed
AAP Standards
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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
Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide
AAP Standards
– Allergies
– Asthma
– Autism
– Diabetes
– Heart conditions & defects
– Seizures
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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
Model Child Care Health Policies
Model Policies
• Available online at Healthy Child Care Pennsylvaniawww.ecels-healthychildcarepa.org
• Available in print from NAEYC
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• 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
The Pediatrician’s Role in Promoting Health and Safety in Child Care
Pediatrician’s Role
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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 [email protected] to be added to the NRC
listserv
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TrainingNational 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
NTI Train-the-Trainer Program:Develop expert-reviewed, rigorous curriculum
Evaluate curriculum materials and training methodsPresent training through distance learning and on-site visit
NTI Trainers:Graduates of NTI’s training program
Develop state/regional curriculum based on NTI curriculumTrain at least 10 CCHCs
Child Care Health Consultants:Trained by NTI Trainers
Provide consultation and other services to child care providers
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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
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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: [email protected]
Web site: http://nti.unc.edu
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www.healthychildcare.orgFor 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] site: www.healthychildcare.org Phone: 888/227-5409
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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, 3rd 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?