Outline of Missouri Missouri State Profile

 

Healthy Child Care Missouri (HCCM) has created an infrastructure that assures child care health consultant (CCHC) coverage in 112 of Missouri’s 114 counties and in four major cities. HCCM and CCHCs are integrated into the Missouri Early Childhood Comprehensive System (ECCS) plan such that they support five of the six key components.

  • Licensing: Missouri does not require health consultation as a condition for licensing or regulation of early childhood education (ECE) facilities.
  • Funding: HCCM is supported in part by the U.S. Department of Health and Human Services, Child Care Bureau and Maternal and Child Health Bureau. The primary funding source is Child Care and Development Fund (CCDF), with additional support from the Title V Maternal and Child Health Block Grant, Missouri Department of Health and Senior Services (MODHSS) funding through the Centers for Disease Control and Prevention, and State of Missouri funding for training.
  • Auspices: HCCM is a collaborative project between the MODHSS and local public health agencies (LPHAs) throughout Missouri. Each LPHA has a contract with the MODHSS with a scope of work describing the CCHC role and services to be provided by the LPHA. LPHAs serve one or more counties through the contract.
  • CCHC Role: Each LPHA assigns a primary CCHC, who is a public health nurse (RN). Other health professionals (e.g., health educators, LPNs, social workers, nutritionists, environmental public health specialists) in the LPHA may serve as CCHCs in collaboration with the primary CCHC. CCHCs provide on–site and telephone consultation and training to early childhood education providers. They also conduct health promotion programs for children and educational sessions for parents of children in child care.
  • CCHC Training: HCCM’s Section for Child Care Regulation (SCCR) conducts an annual training for all CCHCs, as well as a day of orientation for new CCHCs, several times during the year. The Missouri Training Institute for Child Care Health Consultants (MTI), an optional five–day training based on the National Training Institute for Child Care Health Consultants (NTI) training, is also offered annually to CCHCs. Additional optional training on specific issues is available (e.g., 2006 training for CCHCs on disaster preparedness for child care).

History and Development

HCCM developed out of the Healthy Child Care America (HCCA) funding years, during which HCCM staff participated extensively in training opportunities, including sending a team of six to the NTI training. Early in the program, Missouri also sent a team to First Steps training in North Carolina. In turn, this team provided training for CCHCs on inclusion based on the First Steps program. The HCCM MTI training team also participated in an NTI Region VII meeting in Kansas City and a regional training on mental health.

Challenges and Lessons Learned

  • Funding: Current contracts with LPHAs do not contain sufficient funding for LPHAs to designate a primary CCHC and provide the services needed to the child care community.

Ingredients for Success

  • Infrastructure: Missouri has created a statewide CCHC program with consistent preparation for CCHCs to assume this role and resources made available to each contracting LPHA. Each LPHA has received a copy of Caring for Our Children, Model Child Care Health Policies, Healthy Young Children, Managing Infectious Diseases in Child Care and Schools, other resources, and many ready–to–go curricula on health and safety topics to use with providers, parents and children.
  • Collaboration: The program has been strengthened by collaborations with child care resource and referral agencies, Head Start, and MODHSS’ Maternal and Child Health, Chronic Disease Prevention, Health Promotion, Communicable Disease, Environmental Health, and Immunization programs.
  • Commitment of leadership: MODHSS leadership continues to be committed to the goals of HCCM.
  • Tracking and Outcomes: Because of the contract between MODHSS and LPHAs, which requires a primary CCHC and reporting and invoicing of activities, MODHSS’ SCCR is able to track their efforts. In 2006, the program served 2,241 child care facilities, impacting 69,642 children in care. The CCHC program reported 1,769 training hours, 647 hours of on–site consultation, 1,249 phone consultations, and 2,039 health promotion sessions for children. The program distributed a program evaluation to child care providers and addressed the health issues of child passenger safety, safe sleep, required reporting of immunizations, and knowledge of the importance of CPR/AEDs statewide.
  • Resources: The program benefits from its association with Mary Dooling, who serves on the MTI training team. Ms. Dooling is a nationally known CCHC expert.

Moving Forward

  • Plans to Expand the Program: HCCM staff are dedicated to strengthening the program by procuring more funding and growing it. They will also continue to disseminate information about the CCHC services, targeting their outreach efforts to more family child care providers.

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Information as of August 2007