Outline of Minnesota Minnesota State Profile

 
  • Licensing: Licensed child care centers are required to have child care health consultants (CCHCs) who are physicians, public health nurses (PHNs), or registered nurses (RNs); the majority of CCHCs are RNs. CCHCs must review child care centers‘ health policies and practices before initial licensure and repeat the review on an annual basis. For child care centers that serve infants, CCHCs must repeat the review on a monthly basis.
  • Funding: At the state level, child care health consultation is supported through the Title V/Maternal and Child Health (MCH) Block Grant Program and the Child Care and Development Fund (CCDF). Child care centers typically access consultation through contracts with local health jurisdictions (LHJs) and/or on a fee–for–service basis.
  • Auspices: Minnesota does not have a formal lead agency that coordinates child care health consultation and supports its CCHC network. Child care health consultation is supported through a partnership between the Minnesota Department of Human Services (DHS) and Minnesota Department of Health (MDH).
  • CCHC Role: CCHCs provide assessment, consultation (including policy development), and technical assistance on health and safety issues to child care providers.
  • CCHC Training: Under Healthy Child Care America (HCCA), two PHNs were trained through the National Training Institute for Child Care Health Consultants (NTI). As the initial lead agency for CCHCs under HCCA, the Minnesota Department of Education (MDE) modified the NTI training curriculum to create a 1.5–day training that is specific to Minnesota. Healthy Child Care Minnesota (HCCM) trained 36 CCHCs using this curriculum. Since there is no formal lead agency that coordinates child care health consultation and supports the CCHC network, DHS and MDH are exploring ways to provide CCHC–related training at other conferences and workshops. For example, at the last Minnesota Association for the Education of Young Children (MNAEYC) Annual Fall Conference, there was a track for CCHCs.
  • Website: MDH maintains a website for child care and schools.

History and Development

Under Rule 3 (Minnesota Rules, parts 9503.0005 to 9503.0170), Minnesota has required licensed child care centers to have health consultation since 1980. Prior to HCCA, CCHCs worked out of LHJs, and MDH provided ongoing training and technical assistance to CCHCs through monthly meetings.

With the inception of HCCA, Minnesota established HCCM. Since Minnesota already required licensed child care centers to have health consultation, it chose to use HCCA funding to establish a system that focused on children with special health care needs. As outlined in the HCCM fact sheet, its goal is to “increase quality childcare options for families who have children with special health needs. The focus is to increase the capacity of care for children with health and medical needs and emotional/behavioral needs.” Minnesota‘s Early Childhood Development unit, which became part of DHS in 2003, administered HCCM, in partnership with MDH, from 1995 to 2005. When HCCA ended, Minnesota was experiencing funding cuts. In light of these cuts, it re–evaluated programs and services and determined that it would no longer formally coordinate child care health consultation. Since then, Minnesota has not had a lead agency to support the CCHC network. However, MDH maintains an HCCM website and manages a list serve to provide CCHCs with up–to–date information on health and safety issues.

DHS recently used CCDF funding to support a pilot project to reach out to family child care (FCC) providers through the CCHC network. As part of this project, it conducted a needs assessment to determine the best methods for educating FCC providers about health and safety issues. DHS is now exploring ways to continue supporting this and other related projects.

Challenges and Lessons Learned

  • Funding/Lack of Lead Agency for CCHCs: Due to lack of funding, Minnesota no longer has a formal lead agency for CCHCs. Funding would enable Minnesota to designate a lead agency to coordinate child care health consultation and support the CCHC network.
  • Standardization of Training: Before HCCA ended, Minnesota provided standardized training and other support to CCHCs. Now, the Minnesota child care resource and referral (CCR&R) network and other agencies provide health– and safety–related training for child care providers, but it is not standardized. Through HCCM, Minnesota offers the “Health and Safety Consultation in Child Care” video series that was developed with support from the National Resource Center for Health and Safety in Child Care (NRC), NTI, and other HCCA programs. However, the state needs other resources to provide ongoing training and support to CCHCs.
  • Opportunities for School–based Consultation: In addition to providing child care health consultation, Minnesota school nurses have had to increase the formalization of their relationship with extended day school programs to address the health and safety needs of children using school–based care services.

Ingredients for Success

  • Long–Standing CCHC System: As outlined above, Minnesota has required licensed child care centers to have health consultation since 1980. Therefore, it was a leader in developing competencies and setting standards for CCHCs before the inception of HCCA.
  • Public Health Model: Child care health consultation in Minnesota was developed based on a public health model, and its public health foundation and relationships with the LHJs contributed to the comprehensive nature of its approach.
  • Partnerships: As outlined above, child care health consultation is supported through a partnership between DHS and MDH. However, other state and local agencies—including MDE, LHJs, and the Minnesota CCR&R Network—have been critical to Minnesota‘s success.

Moving Forward

  • As outlined above, DHS recently used CCDF funding to support a pilot project to reach out to FCC providers through the CCHC network. However, DHS is uncertain about future funding for this and other related projects. DHS and MDH are in the process of identifying opportunities to collaborate on topics of relevance to CCHCs.

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Information as of August 2006