National Infant & Toddler Child Care Initiative An Overview of Region I Consultants Working with Child Care Settings Serving Infants & Toddlers April

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1 Consultants Working With Child Care Settings, This document was prepared for the April 15, 2009 Region I ACF/Child Care Bureau and National Infant & Toddler Child Care Webinar on consultants working with child care settings serving infants and toddlers. The information was gathered through web search as well as and telephone communication with state contacts and may not include all consultant initiatives in the six New England states. Consultant Disciplines Connecticut: dental, diet, early childhood education, health, mental health, social service Maine: early childhood education, health, inclusion, infant/toddler, mental health, QRS Massachusetts: early intervention, health, mental health New Hampshire: child care expulsion prevention, child care resource and referral, health Rhode Island: developmental screening, health, infant/toddler, mental health, Vermont: early intervention, health, mental health, resource development, specialized child care, STARS Consultants Required by Child Care Licensing Connecticut: Connecticut child care licensing regulations require centers and group homes to engage the following types of consultants: early childhood educational consultant health consultant (who can be a physician, physician s assistant, advanced practice registered nurse, or registered nurse) o All centers and group homes that enroll children up to 24 months of age and those centers and group homes that include children between 2 and 3 years of age must have a weekly health consultant visit Those centers and group homes that enroll children between 2 and 3 years of age on a part-day basis must have a monthly visit. dentist or dental hygienist consultant social service consultant registered dietitian consultant (for programs serving meals). Maine: 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. 1

2 Massachusetts: Massachusetts child care regulations require licensed centerbased and school-age providers to work with child care health consultants. Child care health consultants are licensed physicians, registered nurses, nurse practitioners, or physician s assistants with pediatric or family health training. New Hampshire: New Hampshire child care regulations do not require child care providers to engage consultants. In the case of a licensing violation, providers are mandated to seek consultation, but the type of consultant is not specified. Rhode Island: Rhode Island s regulations require all child care facilities that serve infants less than 18 months old to have a nurse on the premises for 15 hours per week to serve as a health consultant. Facilities that serve children ages 18 months and older must have a licensed physician or registered nurse identified to serve as child care health consultant. Family child care providers are not required to use consultants. Vermont: Vermont s child care licensing regulations do not require child care providers to contract with consultants. Learn more: State Initiatives That Provide Consultants to the Early Care and Education Community Connecticut Maine Health & Education: Most programs find and engage consultant services independently from publically funded initiatives. However, quality funds from the Department of Social Services enable some local School Readiness Councils to fund education and health consultants for programs that receive preschool funds from the State Department of Education. These programs often serve infants and toddlers in addition to preschoolers. Mental Health: The Department of Children and Families funds a network of 20 mental health consultants to provide mental health consultation to programs on an as-needed basis Other Services: The Accreditation Facilitation Project is funded by the Department of Social Services to provide consultation and technical assistance to programs seeking NAEYC accreditation. The Department of Social Services is just beginning to provide targeted technical assistance to programs to implement Connecticut s Early Learning Guidelines. Infant/Toddler Specialist: Maine's Infant/Toddler (IT) Specialist provides statewide technical assistance directly to child care programs and to other early childhood consultants. The IT Specialist has also worked extensively with Maine s Infant Toddler Initiative and Professional Development Committees to promote awareness of infant/toddler issues and to develop 2

3 an infant/toddler credentialing system. The IT Specialist coordinates a variety of training events, including credit-granting Infant/Toddler Institutes Quality Rating System (QRS): In order to reach the highest level of the QRS and receive the highest quality payment for subsidized care, programs must be accredited (or meet Head Start standards) and meet the consultation criteria of the accreditation system. Ongoing, collaborative consultation is only available to programs enrolled in Maine s Quality Rating System. Programs are prioritized for consultation on the basis of program need and sometimes upon the request of child care licensing workers Massachusetts Early Intervention: Regional consultation programs across Massachusetts, in collaboration with the Department of Public Health's Early Intervention Program (EI), support infants and toddlers with disabilities and those who care for them in child care programs. EI consultants provide services to individual children in their natural environments including child care and sometimes provide coaching to child care staff on mental health, health, and other issues. Mental Health: Some child care programs have access to a mental health consultant through one of two different mental health consultation projects funded by the Department of Early Education and Care (EEC): o The Comprehensive Mental Health in Child Care project places a mental health consultant in 14 of the largest child care agencies that also serve children in child welfare through supportive child care slots. These mental health consultants bill third-party payers for about one third of their salaries and are paid by EEC for the remainder. o The Mental Health Consultation Grant Program provides nine grants throughout the state to serve multiple communities with an on-call mental health consultant. However, an EEC study showed that only 22% of mental health consultants feel competent in working with infants and toddlers. Quality Rating Improvement System (QRIS): New QRIS standards, which are currently in draft form for public comment, include standards requiring child care health consultants and mental health consultants. New Hampshire Health: There is currently a Request For Proposals to furnish health and safety consultation services to child care providers in one of the state's 10 Child Care Resource and Referral Network regions (10-DPHS-MCH- CCHCSPlan-02). It is anticipated that one contract will be established with a single vendor for a single region. 3

4 Infant/Toddler Consultation, Technical Assistance, and Mentoring: New Hampshire is providing child care providers with ZERO TO THREE s Preventing Child Abuse and Neglect training and will soon be training facilitators for the Families and Work Institute Mind in the Making training. Programs that participate in both initiatives will receive 12 months of monthly consultation, technical assistance, and mentoring designed to meet the child care provider s needs. Mental Health Child Care Expulsion Prevention: The state is contracted with an agency to maintain a roster of consultants available to provide free consultation to child care providers. Child care program directors and child care family providers can call a number to discuss a child whose special needs and/or behavior are causing difficulty. The contractor assigns a consultant to observe the child and classroom and to provide consultation on meeting the child s needs so that expulsion can be prevented. Resource & Referral: Child care resource and referral specialists provide technical assistance to providers through telephone, , or personal site visits. Rhode Island Mental Health: The Child Care Support Network is an initiative funded by the RI Departments of Health, Human Services, and Maternal and Child Health Bureau. On site mental health consultation is provided to child care centers by the Bradley Early Childhood Clinical Research Center and the Providence Center Early Childhood Institute. Planning and evaluation design began in 2007 and services to the centers began in February Evaluation results from year one of the project show promising results in improving program practice. Vermont Infant/Toddler: The Child Development Division and the State Head Start Collaboration Office currently provide a small amount of consultant support to infant/toddler programs that serve low-income children and that receive enhanced funding to provide quality care. The support consists of monthly conference calls and limited on-site observation and feedback. The consultants are master s-level and experienced infant/toddler care providers and have other relevant qualifications. Mental Health: provides consultation for early care and education programs to enhance their ability to meet the social, emotional, and behavioral needs of the children they serve. QRIS: Vermont STARS offers technical assistance and consultation to programs participating in the STARS program. 4

5 Resource Development Specialists: Child care resource and referral agencies provide on-site consultation for providers seeking to further develop their programs. Specialized Child Care: Funded by the Department for Children and Families, child care specialists provide telephone and on-site consultations with specialized providers of protective services, family support, and special needs child care. Multidisciplinary/Collaborative Consultation Initiatives Connecticut: Since it began providing consultant training in 2002, Connecticut has taken a multidisciplinary approach to implementing the University of North Carolina National Training Institute s consultant training. In 2005, a statewide symposium resulted in a white paper, Creating a Statewide System of Multi- Disciplinary Consultation for Early Care and Education in Connecticut that outlined a receptive state policy and regulatory context and offered practical guidance on design and implementation from existing consultation programs. The state s early childhood comprehensive systems strategic plan recommends the creation of a statewide interdisciplinary consultation system including health, mental health, and education consultation for all early care and education settings. This system is to be achieved through the development of a statewide infrastructure for networking, training, and supporting consultants and for assisting program directors to effectively access and utilize consultation services. Working in partnership with Healthy Child Care New England, Region I Child Care, ZERO TO THREE, and the Connecticut Head Start State Collaboration Office, Healthy Child Care Connecticut (HCCCT) developed and piloted three new training modules focused on infant/toddler development and learning to be incorporated within their annual consultant training based on the University of North Carolina National Training Institute modules. The modules were piloted in the CT Nurses Association (CTNA) day child care health consultant training. In partnership with Part C, CTNA piloted the modules again in the day child care health consultant training. These modules strengthen the interdisciplinary nature of HCCCT s child care health consultant training and focus on building consultant skills and knowledge of resources to support quality infant/toddler care. Maine: Maine has a multidisciplinary Technical Assistance Network for early care and education that includes education specialists, the After School Network director, Head Start grantee support specialists, inclusion specialists, the state infant/toddler specialist, and the state accreditation specialist. New Hampshire: New Hampshire is beginning the process of developing a comprehensive Quality Rating and Improvement System. The state hopes to have funding for multidisciplinary/collaborative consultation in

6 Rhode Island: The Child Care Support Network (CCSN) is a collaboration between the Rhode Island Department of Human Services and the Rhode Island Department of Health. CCSN provides on-site technical assistance to centerbased programs and family child care homes serving children ages birth to 8, with an emphasis on integrating children with special needs, strengthening reciprocal relationships with families, and enhancing the social and emotional well-being of children in care. CCSN s programs offer services to support early childhood mental health consultation, developmental screening (e.g., Watch Me Grow Rhode Island), infant and toddler on-site technical assistance, and health consultation. Vermont: Vermont is developing a consultation model that integrates three primary early childhood programs that provide health prevention/promotion, mental health, and early intervention services. Families would receive services from a primary care coordinator using a single service plan. The long-term vision for Healthy Child Care Vermont/Early Childhood Comprehensive Services is to implement a similar multidisciplinary consultation model for child care providers as well as families. Standards and Supports for Consultants Connecticut Standards: An early childhood education consultant must be a credentialed early childhood specialist with either: o an associate, bachelor s, master s, or doctoral degree in early childhood education, child development, or human development; or o a 4-year degree in a related field with at least 12 credits in child development or early childhood education from an accredited college or university, who also has 2 or more years of experience administering a licensed child day care center that meets standards comparable to those in Connecticut. A health consultant must be a physician, physician s assistant, advanced practice registered nurse, or registered nurse holding a current and valid license in this or another state. A social service consultant must have either: o a baccalaureate degree in social work, with at least 1 year of social work experience under social work supervision; or o a baccalaureate degree in a field that the commissioner deems related to social work, with at least 2 years of social work experience under social work supervision. 6

7 Maine o Healthy Child Care Connecticut (HCCT) began offering annual consultant training based on University of North Carolina s National Training Institute's Child Care Health Consultation curriculum in To further build and support consultants' capacity, in 2003 HCCCT joined with other New England states to create the Healthy Child Care New England (HCCNE) regional collaborative. HCCNE has shared training resources by providing joint training across states to health and other consultants. HCCCT's child care health consultant training modules were also incorporated into Connecticut's mental health consultant training. o Using an interdisciplinary training format, the Connecticut Nurses Association now offers annual child care health consultant training, this is supported by registration fees. In 2007, the annual training began to include infant/toddler modules and to strengthen its focus on building interdisciplinary consultant skills. o Recently, a group of consultants created a Web site for consultants, began publishing a newsletter, and periodically provided forums to support consultants, especially those practicing in for-profit centers. Standards: Consultants must have a minimum of a bachelor s degree (master s degree preferred), as well as experience/knowledge of early childhood development. The education, inclusion, and infant/toddler specialist positions all require degrees in child development or a closely related field. Mental health consultants must have clinical licensure and 20 hours of training in early childhood consultation. Maine is still in the process of developing standards for consultation and planning for development and expansion of a Health Consultation Network. o Members of the Technical Assistance Network meet quarterly to share information and work through field issues related to consultation. This group is also supported by an listserv. The director of Maine Roads to Quality (a professional development center) and the early childhood coordinator of the Center for Community Inclusion and Disabilities Studies plan and facilitate the network s meetings. All consultants in the network have completed the Foundations of Consultation Leadership Institute, a 20-hour training based on Buysse and Wesley s text, Consultation in Early Childhood Settings. 7

8 o The mental health consultants convene quarterly in peer-reflective sessions and also use a listserv, coordinated by the Center for Community Inclusion and Disabilities Studies staff. Massachusetts o Massachusetts Early Childhood Comprehensive Systems (MECCS) is working with the Department of Early Education and Care to host networking/professional development sessions for mental health consultants each year. MECCS also maintains a networking listserv and Web bulletin board for child care health consultants who have attended training provided by MECCS based on the University of North Carolina National Training Institute. MECCS and the Head Start Quality Initiative have provided annual 4-day training for child care health consultants, mental health, Head Start and Early Head Start health and mental health managers, early intervention specialists, registered nurses, and social workers. o New Hampshire Standards: The Together for Kids project and the Connected Beginnings Training Institute have offered a seminar for mental health consultants in Worcester and in Boston. Consultants must have a Trainer/Mentor/Faculty credential in the New Hampshire credentialing system. The minimum requirements are: o a bachelor s degree in early childhood education, or a bachelor s degree in another field with 24 credit hours in early childhood education, or a master s degree in another field with 12 credit hours in early childhood education; o a minimum of 1 year of experience training or teaching adults; o an active membership in a professional organization; and o participation in at least one professional development activity outside of regular duties that provides service to professionals in the field. Child care resource and referral agencies participate in a network that is registered as a 501(c)(3) organization. The contractor for the child care expulsion prevention initiative provides support to the initiative s consultants. 8

9 Rhode Island Standards: Child Care Health consultants must be a registered nurse or licensed practical nurse. Mental Health consultants funded by the Department of Health must be licensed clinicians or someone directly supervised by a licensed clinician. RI is developing a health consultant network. Mental health consultants funded by the Department of Health meet together once a week. Vermont Standards: Vermont is developing an on-site support consultation infrastructure that will include standards for Vermont professionals who support and consult for specific purposes with providers/programs. Vermont hopes to have a searchable database that will assist programs in finding appropriately qualified individuals to meet their needs. The database will include Child Development Associates advisors and accreditation and STARS mentors, as well as the multidisciplinary/collaborative consultation now under development. The Child Development Division is currently funding the Vermont Child Care Providers Association, the Vermont School Age Care network, the Vermont Association for the Education of Young Children (VAEYC), and the Northern Lights Career Development Center to develop and implement mentoring/consulting programs that are coordinated, mutually informed, and will result in a statewide database for these and other support services. VAEYC conducts orientation and training for these programs, as well as regular communication with a designated point person for the mentors. In addition, individuals who provide health and mental health consultation may apply for Child Development Division Professional Development Grants 9

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