Charting Progress for Babies in Child Care

Promote Access to Comprehensive Services

Policy Ideas

What policies can states use to move toward this recommendation?

To move toward this recommendation, states may use multiple policy levers, starting from different points. Potential state policies include:

Licensing

Require in state licensing that child care providers deliver comprehensive services for vulnerable babies and toddlers or link vulnerable children to community resources, and award grants to help providers meet these requirements.
Require in state licensing that child care centers address six comprehensive areas of child development: social, physical, language/literacy, cognitive/intellectual, emotional, and cultural.[1]
Require in state licensing that child care providers receive pre-service training including first aid certification, certification in infant and pediatric CPR, child abuse identification, developmental screening, nutrition, and methods to reduce disease and injury in child care settings.[2]

Subsidy

Provide higher subsidy reimbursement rates to child care providers who deliver comprehensive services to vulnerable babies and toddlers or link vulnerable children to community resources.
Link the state child care subsidy payment rate structure to the state Quality Rating and Improvement System (QRIS) so that child care providers receive higher rates for screening, referral, and provision of comprehensive services to vulnerable babies and toddlers.
Create contracts that pay higher rates and require providers to provide screening, referral, and comprehensive services to vulnerable babies and toddlers.
Provide a single enrollment form that includes child care subsidy eligibility, the Supplemental Nutrition Assistance Program (formerly Food Stamps), state child health insurance programs, and other social service programs.
Provide higher subsidy reimbursement rates for infants and toddlers who have been identified with developmental delays or other special needs.
Allow family, friend, and neighbor caregivers receiving child care subsidies to participate in the federal Child and Adult Care Food Program (CACFP), and put in place policies that make it easier for all providers and caregivers to have continuous access to the program.

Quality Enhancement

Embed provision of screening, referral, and comprehensive services for vulnerable babies and toddlers in child care into the levels of a state Quality Rating and Improvement System (QRIS).

Deliver components of comprehensive services in child care settings:

Create a statewide network of infant and toddler health and mental health specialists to provide technical assistance to infant and toddler providers, caregivers, and parents.
Support child care health consultants with training on infant/toddler development so that they can better serve child care settings where babies are in care.
Create new child care settings or expand the ability of existing center and family child care settings to build on the Early Head Start model by funding child care settings to deliver services that meet the federal Head Start Performance Standards.
Ensure that all eligible child care providers and caregivers have access to the federal Child and Adult Care Food Program (CACFP) in order to provide healthy, nutritious meals and snacks to infants and toddlers in their care.
Create new child care settings delivering comprehensive services in immigrant and language-minority communities.
Fund child care partnerships with Early Head Start programs to allow children in all child care settings, including family, friend and neighbor care, to receive Early Head Start screening and referral services.
Fund connections between family resource coordinators and child care centers to help parents access resources in their community, such as health care, WIC, the Supplemental Nutrition Assistance Program (formerly Food Stamps), social services, and health care.
Ensure that infant/toddler health and mental health specialists, family resource coordinators, and others working with providers and parents are culturally and linguistically representative of families with infants and toddlers and/or have training in cultural competency.
Fund initiatives to provide parent support services, such as home visits, new parent discussion groups, family literacy programs, and birth to three child development classes, in child care settings, and provide services in multiple languages.
Provide guidance to child care programs on eligibility for publicly-funded health services for children and parents who are not U.S. citizens.

Improve child care provider and caregiver understanding of the comprehensive service needs of babies and their families:

Create community-based support networks for family, friend, and neighbor caregivers of babies and toddlers that link children to health and screening services by connecting with trusted community resources such as libraries, museums, immigrant serving organizations, public health, mental health and early intervention, senior service, and public television resources.
Provide training opportunities and support for child care providers and caregivers on how to recognize, work with, make referrals for, and follow up with vulnerable families, including those struggling with poverty, domestic violence, substance abuse, child abuse, and neglect.
Provide training opportunities and support for child care providers and caregivers on the use of screening tools to identify potential health and developmental concerns for babies and toddlers and how to refer families for services and programs that can support parents in nurturing their children's development, including referrals to IDEA Part C early intervention.
Disseminate information to all providers and caregivers on how to access services for special needs infants and toddlers and their families, in culturally and linguistically appropriate ways using multiple languages and multiple formats.
Ensure parents in immigrant communities with babies and toddlers in child care are aware of community services by using face-to-face communications through trusted messengers, including immigrant-serving organizations, and disseminating translated materials appropriate for parents with low literacy levels.
Develop information on the connections between infant health/mental health and maternal mental health, as well as resources for serving infants and their mothers, and disseminate it in multiple languages and multiple formats to providers, caregivers, families, and community health professionals.

Coordinate state systems to connect elements of comprehensive services with child care:

Coordinate state Medicaid and early childhood policies to allow federal funds to support consulting and therapeutic services necessary for vulnerable infants and toddlers in child care and their families, including Early and Periodic Screening and Diagnostic Testing (EPSDT) services.
Coordinate policies between state child care systems and IDEA Part C state early intervention systems to better serve infants and toddlers with special needs.
Coordinate state child care system policies with other state systems that provide developmental services to infants, toddlers, and their families, such as WIC, the Supplemental Nutrition Assistance Program (formerly Food Stamps), social services, and health care.
Ensure that Child Find and other services designed to identify children at-risk of developmental delays are including child care centers and family child care providers in their target service areas.

Related Project Recommendations

1. This policy is a benchmark from the National Association of Childcare Resource and Referral Agencies, We Can Do Better: NACCRRA's Ranking of State Child Care Center Standards and Oversight, 2006, http://www.naccrra.org/policy/state_licensing/.
2. See A Vision for the Reauthorization of Child Care, http://www.nwlc.org/pdf/ChildCareReauthorizationVision.pdf, 2008, and NACCRRA, We Can Do Better.

Visit page: http://www.clasp.org/babiesinchildcare/recommendations?id=0012