• Licensing: Ohio does not require licensed child care centers to engage child care health consultants (CCHCs).
• Funding: The Healthy Child Care Ohio (HCCO) CCHC network is currently supported through funds from Title V Maternal and Child Health Block Grant (MCHBG), Child Care and Development Funds (CCDF) and Part C of IDEA.
• Auspices: As part of HCCO, the Ohio Department of Health, Bureau of Early Intervention Services (ODH), contracts with the Ohio Child Care Resource and Referral Association (OCCRRA) to administer a statewide CCHC network. OCCRRA coordinates the network through subcontracts with partner organizations in nine regions of the state. Partner organizations include children’s hospitals, local health departments, regional resource and referral agencies and Ohio University’s Community Services Program. Nurses with each of the partner organizations provide free training and consultation services on a wide range of health and safety topics to any child care provider in the state, including unregulated family child care homes.
• CCHC Role: CCHCs are registered nurses who offer free health and safety consultation and technical assistance to local child care providers and the families they serve. Child Care Nutrition Consultants (licensed/registered dietitians) are also available to child care providers in half of the state.
• CCHC Training: HCCO’s Coordinator completed the National Training Institute’s train–the–trainer course. The network currently utilizes four core curricula: medication administration, asthma and allergies, SIDS, and handwashing. CCHCs offer training on other health and safety topics as needed. Additional training modules are being developed and will be accessible to all HCCO CCHCs via a password–protected section of the OCCRRA website.
• Website: OCCRRA’s website has information about CCHC services, contact information for providers seeking CCHCs, and consultant utilization data.

History and Development

In 2001, Ohio established its CCHC network using HCCA and Title V funding and later added CCDF and Part C of IDEA money. In 2004, HCCO piloted a Child Care Nutrition Consultant program in child care settings in two of the nine regions. In the pilot program, licensed/registered dieticians provided support to child care centers on topics involving nutrition, food safety, modified diets, and feeding practices.

The HCCA objectives have been incorporated into the ECCS project while maintaining the HCCO program. The HCCO Project Director and Program Coordinator are also responsible for the ECCS project. CCHCs’ connect HCCO’s goals with ECCS’s in several ways. In each initial consultation, CCHCs must address SIDS risk reduction, reinforce the importance of medical homes for all children, and support families in accessing health insurance. The CCHCs also provide information to families on resources and supports through local community events, such as health care fairs.

Challenges and Lessons Learned

• Marketing the CCHCs: Many child care providers continue to be unaware of CCHCs’ services, in spite of numerous outreach efforts. Increased collaboration with related initiatives (Infant Toddler Specialists, quality rating systems, etc.) encouraged cross–referrals. The availability of preschool vision screenings contributed significantly to initial contacts with CCHCs. The development and implementation of a specific marketing plan for the HCCO network is expected to raise awareness.
• Narrowing the Focus: From the networks’ inception, child care providers contacted CCHCs for free training and consultation on a broad range of needs. While the network was being established, CCHCs accommodated the wide array of requests. In the process, however, multiple versions of resources were developed without a standardized format. In addition, CCHCs found it difficult to define a scope of work. A clear, delineated future direction of CCHC activities has since emerged from available data on critical priorities, a needs assessment, and MCH priorities. HCCO is creating standardized training modules that can be adapted by CCHCs to meet individual audiences’ needs.

Ingredients for Success

• Vision Screenings: Vision screening services sparked child care providers’ interest in CCHCs’ services and improved the quality of life and health for the state’s young children. In 2004, with the support of the Prevent Blindness Ohio initiative, HCCO trained and certified the entire CCHC network in vision screening. CCHCs performed vision screenings across the state for almost 3000 children that year. They followed up with providers that served children with problematic screens, and helped providers refer families to health professionals for further evaluation.
• Partnerships: Collaboration enables HCCO to share information and advocate for changes in policy that support healthy out–of–home care. Through a partnership with the Ohio Department of Job and Family Services (ODJFS), HCCO contributes to child care rules revision, helps disseminate changes to rules through the CCHC network and provides technical assistance on a variety of early care and education activities. ODJFS provides support to the HCCO program by contributing CCDF dollars through an interagency agreement and promoting HCCO resources on their website.
• Outreach to Pediatricians: HCCO engages doctors in the network’s mission to better serve and inform families. HCCO conducted eight forums to provide pediatricians with information on advising patients’ families on how to recognize safe, healthy, and high–quality out–of–home–care. Pediatrician Consultants have been recruited in each of the nine regions of the state and will serve as a resource and support for the CCHCs in their area.

Moving Forward

• Evaluation: Ohio’s ECCS grant provided funding for a statewide quality improvement evaluation to determine the CCHC network’s future needs and to identify suggested improvements. HCCO is using the evaluation results to help focus planning and to prioritize CCHCs’ services. In addition, performance–based outcome measures are emerging and will be incorporated into ongoing evaluation efforts.
• Special Needs: CCHCs were trained on the inclusive child care curriculum “Child Care plus+” and are offering training for child care providers on inclusion of children with special needs.
• Hearing Screenings: CCHCs will also offer preschool hearing screenings. Hearing screenings have been identified as an MCH state performance measure for Ohio. In response to frequent requests, funding is being provided through MCH and ODH to purchase equipment and train CCHCs.
• Web–based Data Reporting: A new web–based reporting system will allow CCHCs to document all encounters with providers and families electronically, thus reducing data collection errors, increasing consistency in reporting and mainstreaming reporting on networking activities.

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Information as of August 2006

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