Healthy Child Care

With so many families needing to access out-of-home care for their children, the quality of that care is an increasing concern. One characteristic that a quality child care program must have is services to enhance the health and safety of children. Following the basic regulations for operating a child care facility does not necessarily ensure that quality is offered. Child care health consultants offer an avenue for increasing the quality of health and safety issues that benefit child care providers, children and their families.

The services offered by child care health consultants are not required through licensing regulations. Health consultation is suggested by the Maternal and Child Health Bureau as a standard most needed to protect children from harm in out-of-home settings. The Maternal and Child Health Division of the North Dakota Department of Health supports this recommendation by providing a state-level nurse consultant. This nurse consultant works closely with the child care health consultants by providing leadership and consultation services, infrastructure support, orientation training oversight and facilitation of the CCHC quarterly meetings.

Requirements for North Dakota Child Care Health Consultants

Child care health consultants must have expertise in the following areas:

• Early brain development and child development
• Health and safety standards and education
• Infection control standards and practices
• Environmental health
• Mental health
• Nutrition
• Oral health
• Emergency preparedness
• Developmentally appropriate practices
• Adult teaching strategies
• Community resources
• Familiarity with child care licensing regulations.

There are four levels of involvement that exist for child care health consultants. These include:

Level One - Primary care clinicians that support parents searching for child care by providing information to parents about child care health and safety issues during well-child visits.

Level Two - Child care advocates who present educational sessions to parents or child care providers on child care health and safety issues or who serve on a local advisory board or in an advisory capacity to a child care program. This may include public health nurses, school nurses, pediatric nurses, nurse practitioners and other health professionals within the community.

Level Three - Child care health consultants who provide health and safety consultation services to child care programs or who assess health and safety risks and develop an action plan to remedy hazards through on-site visits to child care settings. All North Dakota Child Care Health Consultants employed/contracted with Child Care Resource and Referral must be at this level. It is the responsibility of the CCHC to train and collaborate with local community professionals at the level one and two involvement.

Level Four - Train the Trainers (National Training Institute). These are consultants who train others to serve in the role of child care health consultant. It is the responsibility of these trainers to train and collaborate with local community professionals at the level one and two involvement and to provide orientation training to all new CCR&R child care health consultants at the level three involvement.

Roles of the North Dakota Child Care Health Consultant

For children and families:

• Provide consultation on various health and safety issues
• Connect children with special health care needs to community resources
• Provide referrals to the primary care provider or other community services
• Encourage and assist with the establishment of a single point of health care (medical home)

Child care providers:

• Provide consultation and education to staff about child development, health and safety issues, nutrition, immunizations, accommodating children with special health care needs, infection control practices, etc.
• Offer clarification on best practices for health and safety issues, exclusion policies, etc.
• Identify health and safety risks and help develop a plan to correct problems
• Provide health and safety resources
• Help develop and implement infection control practices
• Build awareness of the medical home and community services

Community:

• Promote quality child care
• Advocate for policies that promote health and safe care for children
• Serve as a connection between child care and other community agencies through relationship building

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