Child care health consultation: A statewide approach to improve child care quality utilizing a health promotion program for young children

In 2009, Arizona established Quality First, a child care quality improvement and ratings system. A key component of the program has been the availability of Child Care Health Consultants (CCHC's). CCHC's are trained public health nurses who assist child care providers in addressing health and safety needs. Child care providers have children in their care for many hours each day and are expected to effectively prevent injury and illness while promoting healthy behaviors. Often they do this without the benfit of medical training. Improving quality in child care programs cannot be achieved without addressing health and safety issues, thus Arizona decided to make the CCHC available to all participating programs. As implementation of the program has gone forward, the program model has evolved based upon the data that has been collected. In the fall of 2011, the model changed to a tiered service delivery model where child care providers receive services based upon individual need as opposed to a one size fits all program.

This presentation will describe the model both before and after the change, the challenges in making such a significant change, and the resulting impact on Quality Improvement ratings. How much of an impact did client desire and readiness to participate make in the ultimate rating of the program?

Lessons learned from the process can be utilized by anyone developing a similar program or considering a change to a program model after implementation.