• Licensing: The Oregon Department of Human Services (ODHS) does not mandate child care health consultants (CCHCs) by licensing or regulation. CCHCs are health professionals from a variety of disciplines who meet program experience competency requirements. Typically, they are public health nurses, health educators, and mental health professionals.
• Funding: The Child Care Health Consultation Program (CCHCP) is funded primarily through the Title V Maternal and Child Health Block Grant Program and the Child Care and Development Fund (CCDF). ODHS encourages program sites to provide matching resources to expand and sustain services. However, to date, only the Clackamas County site has other funding (e.g., local funds, Great Start, Family Preservation and Support).
• Auspices: The CCHCP is administered by the ODHS Office of Family Health (ODHS–OFH). Although the CCHCP is administered by ODHS–OFH, it was implemented as a collaborative effort between ODHS–OFH; Oregon Employment Department, Child Care Division (OED–CCD); Oregon Child Care Resource and Referral (CCR&R) Network; and the Oregon Commission on Children & Families. The Childhood Care & Education Coordinating Council’s Child Care Health Links Advisory Committee, which is staffed by ODHS and includes state and local child care and health care partners, assists with program development and implementation.
• CCHC Role: As outlined on the Healthy Child Care Oregon (HCCO) website, CCHCs “provide direct support to child care providers through training and telephone and on–site consultation regarding child health, safety, and the promotion of healthy social and emotional development to improve child health.”
• CCHC Training: ODHS provides an orientation for all program staff that includes information about program goals, objectives, activities, and evaluation processes. Those who directly consult with child care providers regarding physical and/or challenging behavior issues receive training to build consultation and training skills. They also receive training on the Promoting First Relationships curriculum to strengthen consultation on children’s healthy social and emotional development and behavior. CCHCs receive five additional training modules on health and safety topics. The modules are based on the National Training Institute for Child Care Health Consultants (NTI) materials and Healthy Child Care Washington’s CCHC training outlines that are adjusted to include information related to Oregon’s health and early childhood education (ECE) systems. Continued training on a variety of topics are offered at team consultation trainings or “roundtables.” These meetings also incorporate development of program policies, procedures, and evaluation techniques.
• Website: HCCO maintains a website.

History and Development

In 2001, ODHS–OFH received a Healthy Tomorrows grant to being planning for a child care health consultation program. State staff attended the NTI training, and stakeholders began to plan for the implementation of a demonstration program in Oregon. ODHS–OFH and OED–CCD dedicated Title V and CCDF funds to support it. In March 2003, ODHS selected four projects to be part of the CCHCP. These projects were located in Baker, Jackson, Lincoln, and Multnomah counties. Phase I began in summer 2003 and continued through June 2004; this phase was primarily developmental. Project activities included hiring/identifying a CCHC and CCR&R specialist in each county and establishing local Community Child Care Health Coordinating Groups—including representatives from child care, health, mental health, local commissions on children and families, and local health departments—to provide support to CCHCs and referrals to community health resources. Other Phase I activities included providing three team consultation trainings (“roundtables”); conducting needs assessments with child care providers, workers, and families; building relationships with community partners; and starting strategy–building sessions. In addition, each project site began providing consultation services and evaluation activities.

During Phase II (July 2004–June 2005), project activities included enhancing relationships with community partners, making necessary adjustments in staffing and activities, and expanding evaluation (including semiannual site visits). During Phase III (July 2005–June 2006), the project sites strengthened consultation on social and emotional health issues, and mental health consultants were included as members of each local project core team. ODHS and the Oregon CCR&R Network participated in a Promoting First Relationships training of trainers and developed protocols for consulting on social and emotional health issues. In addition, ODHS added a fifth project site located in Clackamas County. During Phase IV (July 2006–June 2007), ODHS and its partners continued to enhance service delivery, evaluate the program with added attention given to social and emotional health consultation services, and building infrastructure to promote sustainability.

Challenges and Lessons Learned

• Funding: Funding is the biggest challenge. ODHS and its partners continue to seek and encourage the use of funds from a variety of sources, in addition to Title V and CCDF funds, to support the CCHCP. Stakeholders are planning for incremental expansion of the program across the state and believe that it is critical for funding to be consistent, ongoing, and growing.
• Family Child Care Linkages: Although all providers are served, the program has prioritized family child care providers because they provide the majority of care in Oregon. They are typically the most difficult group of providers to engage. ODHS and its partners learned that family child care providers are receptive to child care health consultation. Seventy-seven percent (77%) of providers who received services were family child care providers. Both providers who are licensed and those who are exempt from licensing are accessing consultation services. Conducting needs assessments and building relationships with family child care providers were critical to the success of the state’s CCHC efforts.
• Building Bridges Between Early Care and Education (ECE) and Health: The ECE and health communities are learning how healthy growth and physical and social/emotional development support optimal cognitive development. They have been receptive to integrating CCHCs into ECE settings. The challenge is to create and sustain partnerships and resources to do the work together.
• Honoring Partners’ Strengths and Contributions: ODHS and its partners have devoted a great deal of time and effort to recognizing the specific and unique contributions of the various service providers who are involved in the CCHCP and to finding ways to bring each provider’s expertise to the CCHCP. The formation and expansion of the local multidisciplinary Health Resource Teams and the use of reflective team consultation has supported the members and strengthened the teams. Acknowledging and celebrating program successes together at state roundtables and incorporating local feedback into program design has deepened commitment and satisfaction of the project staff and partners.

Ingredients for Success

• Partnerships: ODHS worked hard to build relationships with other agencies, and these relationships have been critical to building community support. Key partners are local and state public health and CCR&R systems, OED–CCD, and the mental health community. Stakeholders have found that shared decision–making and blended funding support these partnerships and consultation services.
• Strong Community Support: The CCHCP has strong community support where the projects exist because strategies in each project are based on an assessment of the specific and unique needs of each community/project site. In addition, ODHS and the project sites worked hard to build relationships with community partners to demonstrate how child care health consultation fits into communities’ ECE plans and to ensure that child care health consultation was embedded into these plans. The local programs are advised by the Community Child Care Health Coordinating Group made up of local stakeholders.
• Strong Evaluation: ODHS opted to start the CCHCP in four counties and to include a strong evaluation component to use to make adjustments in activities, improve child care outcomes, and show the impact of services. The evaluation component continues to be a vital and dynamic element of the program.
• Commitment to Sustainability: ODHS and its partners are committed to finding ways to fund the CCHCP after Phase IV ends in June 2007.

Moving Forward

• Striving to Build and Strengthen CCHC Infrastructure: Child care health consultation has been supported as a promising practice by national research studies. In Oregon, support for health consultation can be found in the state Early Childhood Comprehensive System (ECCS) plan, as well as recommendations from the Early Childhood Mental Health Summit 2002, and is included in the Oregon Model 2005. ODHS and its partners are moving the program from a demonstration program to a growing state program that will contribute to the array of services that support children’s health in Oregon. They are developing strategies to not only continue funding for the program, but to expand it incrementally to all child care providers in the state. Development grants will be issued in 2007 to communities that wish to plan for a local program.

Top

Information as of August 2007

HCCC-NSC is a part of EDC’s Center for Children & Familites.
Site hosted by Education Development Center, Inc. ©2006 Education Development Center, Inc. All Rights Reserved.

This website was developed with funding from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services under contract number HHSH240200535013C.