The child care health consultant (CCHC) is a specialized role with the primary goal of promoting the safest and healthiest environment for the staff and children in child care settings, including child care centers, nursery schools, and camps. CCHCs guide the child care program in adhering to the local and state regulations, then go above and beyond those standards to promote a higher level of quality.

I have been a CCHC for more than 24 years and am often asked about the role. Here are the answers to some common questions.

What is the role of the CCHC?

CCHCs are health professionals who work directly with child care providers in child care settings and provide consulting services, community resource information, and referrals. The goal is to promote a safe, healthy environment for staff and children. To achieve that goal, CCHCs work with families, childcare staff, and healthcare providers to ensure all children have all of their needs met and are able to fully participate in the child care program. They also work to reduce the incidence of injuries, decrease the spread of infection, and facilitate well child preventative care. CCHCs may consult either by phone or on site, depending on the program’s needs.

CCHCs interact with a multidisciplinary team, so forging relationships based on mutual respect is an essential part of the role. In addition to families, staff, and clinicians, CCHCs interact with the child care teacher at the point of care, local public health staff, state child care health consultant, child care resources, referral agencies, and the National Association for the Education of Young Children (NAEYC), which accredits early childhood education programs. CCHCs have to balance the needs and goals of these various stakeholders while maintaining a clear vision on how the child can receive the most benefit.

The CCHC also provides educational classes and inservices to early child care educators (ECCEs) such as first aid, cardiopulmonary resuscitation, medications, diabetes, seizures, EpiPen, and promotion of health and safety.

What skills are needed to be a CCHC?

CCHCs must have expertise in child health and developmental milestones across all ages. They must also understand the needs of children, including those with special needs, in the child care setting. Having healthcare expertise isn’t enough. CCHCs also must be able to serve in a consulting role, where organizations may or may not choose to follow the consultant’s suggestions. The CCHC must understand that his or her role is that of consultant and not regulator.

The requirements for the CCHC vary by state. For example, in Connecticut the Office of Early Child Care (OEC) requires the CCHC to be a registered nurse (RN), advanced practice registered nurse (APRN), physician assistant (PA), or physician (MD). Connecticut also requires a weekly nursing consultation when children in attendance are less than three years of age. Rhode Island mandates that a nurse is present at the program 3 hours a day when there are children less than 18 months of age enrolled. In contrast, Colorado requires only a monthly health consultation. Directives throughout the country vary greatly, from monthly or quarterly consultations to a complete lack of CCHC obligation.

What is the typical fee for a CCHC?

CCHCs are usually paid an hourly rate ranging from $75 to $100 depending on the geographic location of the childcare program and the CCHC’s expertise.

What are some dos and don’ts of being a CCHC?

Here are a few considerations to keep in mind.

• Before signing a contract, meet with the program’s owner and director to identify the primary focus of the consultation, the specific needs, and the priority of those needs. For instance, outdated physicals or medication forms need to be addressed early on.
• During the meeting, develop a relationship with the director and staff so they feel free to discuss the health of all the children in the program.
• Be organized.
• Have strategies and resources in mind for various situations. For example, when parents inquire about the development of their child, plan to explain the importance of early intervention, refer them to Make the First Five Count program, and provide them with contact information for Birth to Three.
• Don’t pretend to know all the answers, but instead include the teachers and their input in the resolution of the issue at hand. For example, when the child care teacher asks about a certain condition or child, first ask the teacher what he or she thinks.
• Keep the focus on identifying the safety and health concerns of the children in the program and then collaborate with the staff as to the best approach to ensure that the needs of the child are being met.
• Provide positive feedback in addition to ideas for improvement. Acknowledge the hard work and accomplishments of the staff.
• Don’t expect immediate results. Be patient.

Helping children be successful

CCHCs improve the quality and safety of children in their respective childcare programs. One of the most important parts of the role is to ensure that children in these programs receive early intervention for health and educational needs to enable them to achieve success throughout their academic careers.

Robin Young-Cournoyer is an assistant nursing professor and course coordinator for pediatrics and obstetrics at Goodwin College in East Hartford, Connecticut, and president of Nurse Consultants, LLC, in North Granby, Connecticut.