Outline of Hawaii Hawaii State Profile

 

Healthy Child Care Hawaii (HCCH) conducts training for public health nurses and pediatricians and provides child care health and safety resource materials to those who are trained.

  • Licensing: Child care health consultation is required for licensed early care and education (ECE) programs in Hawaii including center-based, family child care, infant/toddler, and school-age care. For centers and infant/toddler care, the regulations state that all programs shall have provisions for health consultation to assist in developing health policies and keeping them current.
  • Funding: In the Hawaii model, pediatricians serve as CCHCs on a volunteer basis. The Department of Human Services (DHS) uses Child Care and Development Fund (CCDF) monies to support HCCH activities.
  • Auspices: The home agency for HCCH is the State Department of Health, Children with Special Health Needs Branch.
  • CCHC Training: Pediatric residents at the University of Hawaii complete a community pediatrics rotation which includes exposure (but no formal training) on child care quality and health and safety issues for ECE programs. In 2007 HCCH is training public health nurses (PHNs) and health consultants listed for licensing by ECE programs, but not yet trained by HCCH, throughout the state in order to build CCHC capacity.  PHNs in Hawaii have many competing priorities and limited time; consequently they tend to provide telephone-based rather than on-site consultation. HCCH is building their capacity to respond to concerns that come to them from ECE providers by providing training on health and safety in child care and providing child care health and safety resources.
  • Mental Health: Consultation to ECE providers on social emotional and behavioral issues is available through Keiki Care. This program represents collaboration between the Early Intervention Section of the Department of Health (DOH), Child and Adolescent Mental Health Division, and DHS. In 2007, demand for mental health consultation exceeds service capacity levels.

History and Development

Hawaii’s vision for young children was formally adopted by the legislature in 1998 through a resolution that all of Hawaii’s children will be safe, healthy, and ready to succeed. In 2000, the Healthy Child Care Hawaii initiative began.

HCCH works together with Hawaii’s Early Childhood Comprehensive Systems (ECCS) project to promote Healthy Child Care America objectives, including access to medical homes, universal access to developmental screening, and standards-based health and safety practices in child care.

The lead agency for ECCS in Hawaii is the Family Health Services Division of DOH. A strategic management team—composed of representatives from key state agencies as well as parent representatives and community stakeholders—has guided ECCS planning.

In addition to the current and planned efforts of HCCH and ECCS, several statewide ECE initiatives are underway. Kamehameha Schools, a leading educational institution for Native Hawaiians, has adopted a focus on children prenatal to age eight. And, Governor Lingle is leading an ECE initiative.

Challenges and Lessons Learned

  • Reliance on Volunteers: HCCH leaders report that it is difficult to build a CCHC system based on a volunteer cadre of consultants.

Ingredients for Success

  • Shared Vision: Young children are a public policy priority in Hawaii. The legislature has formally adopted a vision for all children to be safe, healthy, and ready to succeed. This vision has been embraced by multiple entities working on aspects of a system for comprehensive ECE services.
  • Leadership: Governor Lingle and the Hawaii State Legislature have promoted early childhood initiatives and created enabling legislation for early childhood initiatives.
  • Partnership: Strong public leadership and the development of public/private partnerships have raised the profile of ECE and created opportunities for integrating systems to meet health, education, and social emotional needs.

Moving Forward

  • ECE Task Force: The Hawaii State Legislature has created a task force to develop a comprehensive ECE plan, to be submitted in 2008. This plan is an opportunity to further articulate the intersection among health, safety, and ECE within the state’s public and private sectors.
  • Standardized Early Child Care Health Record: The Hawaii Department of Human Services, with HCCH, has developed a standardized early childhood health record form for use in child care.  The form is being piloted by several ECE programs as part of their documents for school entry for the 2007-2008 school year.
  • Developmental Screening: Community Health Center providers and other community physicians and their staff are being trained on Parent Evaluation of Developmental Status (PEDS), Ages and Stages Questionnaires (ASQ), and the Ages and Stages Questionnaires: Social Emotional (ASQ-SE), in order to promote universal developmental screening for all of Hawaii.

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Information as of August 2007