Outline of Maine Maine State Profile

 
  • Licensing: For licensed child care facilities serving 13 or more children, Maine regulations require providers to have a written consultation agreement with a physician, nurse practitioner, physician’s assistant, or nurse with child care or pediatric experience.
  • Funding: Maine’s Early Childhood Comprehensive System (ECCS) Project helps support the cost of training child care health consultants (CCHCs). The Child Care and Development Fund (CCDF) supports the child care program specialist who coordinates Healthy Child Care America (HCCA) efforts. Consultants often provide their services on a pro bono basis.
  • Auspices: ECCS and the state’s child care program operate within the Department of Health and Human Services, Office of Child and Family Services, Division of Early Childhood Services.
  • CCHC Role: Consultants provide technical assistance (TA) concerning health policy and children with special health needs, as well as guidance on navigating the national accreditation process.
  • CCHC Training: Maine participates in the Healthy Child Care New England (HCCNE) regional collaborative to conduct an annual, four-day intensive CCHC training. Additionally, CCDF supports an annual, day-long health and safety conference geared towards child care providers and open to CCHC attendance.

History and Development

In the early years of HCCA, the Department of Health and Human Services’ former Office of Child Care and Head Start partnered with the University of Maine’s Center for Community Inclusion & Disability Studies to create the Child Care Plus Maine initiative. While the health consultation portion of this initiative was de-funded, a mental health consultant continues to serve providers across the state. The Child Care Plus Maine initiative also provides TA to early care and education (ECE) providers around the issue of inclusion of children with special needs.

In lieu of a statewide infrastructure, providers frequently access their local doctors to provide health consultation services on a pro bono basis. A few larger center-based providers in southern Maine access consultants on a fee-for-service basis.

When the Office of Child Care and Head Start had the Healthy Child Care America grant, the work of the grant included health consultant training. Three nurses were sent to the National Training Institute for Child Care Health Consultants (NTI).  These consultants worked with staff within the Office of Child Care and Head Start to offer the New England Health Consultant Training five times.  Staff within the office developed a data base of CCHCs and made information available to providers on the role of CCHC.  Technical assistance was provided to child care centers on the development of a health care plan.

Since 2003, Maine has carried out its ECCS Project—called the Early Childhood Initiative—through the Governor’s Children’s Cabinet, chaired by the First Lady. This executive-level committee, including the Attorney General and other state government leaders, developed a state system plan in 2005 that included a recommendation for the development of a statewide system to deploy, reimburse, and access CCHCs.

In 2005, Maine received funds from a private foundation to support a partnership effort among its state chapter of the American Academy of Pediatrics (AAP), the Early Childhood Initiative, and HCCA. With funding, the partners can create more opportunities to raise awareness and draw attention to the importance of supporting children’s health and safety through a state child care health consultation system.

Challenges and Lessons Learned

  • Funding Loss: The loss of the Healthy Child Care America grant funds and Department staff shortages have limited the time and money spent on developing a health consultant network. 

Ingredients for Success

  • Engaging School Nurses: As part of the HCCNE regional training series, Maine reached out to include school nurses as participants and potential CCHCs. The nurses were enthusiastic about the potential of a comprehensive system that promotes health and safety in ECE settings and follows the child into elementary education.
  • Multi-Disciplinary Training: Maine’s Cost and Quality study found that a common need among caregivers/teachers is more specialized social-emotional health training. This finding supported a recommendation for the creation of a statewide consultation infrastructure and the participation in multi-disciplinary training with the HCCNE regional collaborative.

Moving Forward

  • Solidify CCHC Infrastructure: A priority for Maine’s ECCS implementation is to solidify the child care consultation infrastructure across several state entities.
  • Coordination with AAP Child Care Contact:   Discussion with the AAP child care contact may lead to more interagency work on a child care health consultant infrastructure.

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Information as of August 2006