Outline of Colorado Colorado State Profile

 

The Healthy Child Care Colorado (HCCC) Program operates out of Qualistar Early Learning (QEL)—the child care resource and referral network office (CCR&R) for the state—in collaboration with The Children’s Hospital, the Colorado Department of Public Health and Environment (CDPHE), and the Colorado Department of Human Services (CDHS).

  • Licensing: Colorado’s licensing regulations require child care centers to have monthly visits by a child care health consultant (CCHC) with delegatory authority, that is, a licensed RN, NP, or MD.
  • Funding: HCCC is supported by several different funding sources including the Title V Maternal and Child Health Block Grant, Child Care and Development Fund (CCDF) through the CDHS, The Children’s Hospital, and QEL.
  • Auspices: The CDPHE contracts with QEL for HCCC project activities. The HCCC project coordinator operates out of QEL as an employee of The Children’s Hospital.
  • CCHC Role: CCHCs provide mandated medication administration training and evaluation for child care centers and may also provide all other services according to the definition of the role by the National Training Institute for Child Care Health Consultants (NTI) curriculum as well as services defined by licensing rules.
  • CCHC Training: HCCC offers a one-day CCHC training four or five times a year that covers the role of the CCHC, consultation skills, and one or two specific early childhood education (ECE) health topics (e.g., challenging behaviors, asthma, nutrition update). Training attendees are given many resources on child care and child development including the NTI training modules on a CD. The CCHC training is not required for individuals to provide child care health consultation to child care centers.
  • Website: QEL provides a website where ECE providers can identify consultants who have received the CCHC training. HCCC also offers a free introductory online training about the role of the CCHC which takes about 45 minutes to complete.

History and Development

The driving force for the formal development of CCHCs in Colorado occurred in 2001, when the state legislature required that ECE center–based programs receive monthly child care health consultation as a licensing requirement. This dovetailed well with HCCC goals and objectives. HCCC had been developing health-related trainings and resources (e.g., universal precautions in child care facilities, child abuse and neglect, child growth and development). With the new legislation, HCCC developed a strategic partnership with the local chapter of the American Academy of Pediatrics (AAP) and standardized a curriculum on medicine administration. In preparing for the new rules to take effect, the HCCC coordinator participated in NTI training. Following the coordinator’s return, HCCC developed an abbreviated training to prepare a large cadre of CCHCs quickly to meet the needs of ECE centers.

Challenges and Lessons Learned

  • Funding: The current funding arrangement, while meeting the immediate budgetary needs of HCCC, does not serve as a permanent funding stream for the program. This makes long-term sustainability of the program an ongoing issue.

Ingredients for Success

  • Licensing: The program has benefited from the regulatory requirement for child care health consultation.
  • Collaboration: Collaborations with health and education organizations and agencies have created wide awareness of the role and importance of child care health consultation in the state. For example, partnering with and being housed in QEL has provided immediate access to CCR&Rs and through them access to communities.
  • Cross-training: HCCC staff provide mini–trainings for other professionals. Training about the role of the CCHC is integrated into the orientation of new licensing professionals. Staff also regularly present to Child Care Learning Communities (local child care coalitions) on different topics depending on their interests. These topics have included inclusion of children with special health care needs, behavioral concerns, and increasing immunizations. The staff also conduct less formal trainings for local CCR&R offices upon request.

Moving Forward

  • Training Scholarships to Build Local Infrastructure: HCCC provides scholarships for public health nurses at the local health departments (LHDs) to attend training and enhance local infrastructure as some of the LHDs provide a network structure for CCHCs in their areas.
  • Reevaluating Training: HCCC will continue to monitor the training needs of nurses and providers, and offer training that is specific to those needs.
  • Reaching Parents and Providers: HCCC staff are identifying collaborations for disseminating information about child health and safety directly to parents and child care providers. Some possible partnerships include working with existing community-based programs to reduce child exposure to secondhand smoke, encourage appropriate antibiotic use, and reduce the impact of asthma. In February 2007, the Child Health Liaison online course was launched on the CO.TRAIN website. This free health and safety training is a resource for ECE providers interested in improving health and safety in their programs. The ten-module course is appropriate for anyone providing out–of–home care, including providers in family child care homes, Head Start programs, child care centers, and preschools. CCHCs are also being directed to this training. Completion of all ten modules including a final exam is equivalent to 15 contact hours.

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Information as of August 2007