Indiana: Requiring Continuity of Care in Licensing

May 22, 2009

Continuity of care refers to a set of policies and practices designed to attach a primary caregiver to an infant for the duration of the infant\'s enrollment in care, up to age 3. In Section 51 of the Indiana child care center licensing rules, adopted in 2003, Indiana requires child care centers to make a "reasonable effort" to achieve continuity of care for infants and toddler up to 30 months of age. Complementing the continuity of care regulation, Section 52 of the rules allows for mixed age grouping up to age three under specified conditions.

Indiana\'s Bureau of Child Care released Interpretative Guidelines in 2007 to provide examples of how a center may demonstrate a reasonable effort to achieve continuity of care, including: 

  • Moving the teacher with their children to another classroom as the children mature;
  • Modifying the classroom as the children mature;
  • Creating mixed age groupings of children, ages six weeks to 36 months; or
  • Creating intentional transitions that prepare children as they move into the next age classroom.

Child care center directors were among both the strongest proponents and the most vociferous opponents of the continuity of care rule. Its adoption was made more feasible by allowing existing centers to take one year to meet the new standard and tempering the requirement to one of "reasonable effort" to achieve continuity of care. Indiana adopted its continuity of caregiver regulation as part of a comprehensive overhaul of its child care center regulations, recognizing that the benefits of continuity of care depend also on a commitment to a primary caregiver and a small group size. In addition to embedding its continuity of care rule in an overall policy approach to infants and toddlers, Indiana has invested in developing the quality of infant-toddler care. Indiana\'s Child Care and Development Fund State Plan provides for funding a statewide network of infant-toddler specialists in each of the state\'s 11 child care resource and referral agencies.

The continuity of care regulation has been a catalyst for infant-toddler specialists and problem-solving licensing consultants to create a vibrant learning community focused on creating high quality infant-toddler care. Purdue University\'s Department of Child and Family Studies\' evaluation of the work of the 4C of Southern Indiana, the child care resource and referral agency, found that promoting implementation of the continuity of care regulation contributed to higher levels of quality among infant-toddler child care providers as measured by the ITERS and FDCRS environmental rating scales. 


State contact information:

Melanie Brizzi, Administrator
Indiana Bureau of Child Care
Department of Family and Social Services Administration
(317) 234-3313


See all Charting Progress for Babies in Child Care State Examples.

Read more about the project recommendation to Promote Continuity of Care, including research, policy ideas, and links to online resources.

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