Sponsored by the U. S. Department of Health and Human Services, Child Care Bureau, Administration on Children, Youth, and Families, Administration for Children and Families and the Maternal and Child Health Bureau, Health Resources and Services Administration, Public Health Service.

Goals:

• Safe, healthy child care environments for all children, including those with special health needs.
• Up-to-date and easily accessible immunizations for children in child care.
• Access to quality health, dental, and developmental screening and comprehensive follow-up for children in child care.
• Health and mental health consultation, support, and education for all families, children, and child care providers.
• Health, nutrition, and safety education for children in child care, their families, and child care providers.

Every day, millions of our young children leave home to spend part or most of their day in some type of child care setting. Children participate in child care in a variety of settings, such as child care centers, family child care homes, or in-home care, at various hours of the day. In just 20 years, the percentage of children enrolled in child care has soared from 30 percent (1970) to 70 percent (1993). By the year 2000, 75 percent of women with children under 5 years of age will be employed - and in need of child care.

The Healthy Child Care America Campaign is based on the principle that families, child care providers, and health care providers in partnership can promote the healthy development of young children in child care and increase access to preventive health services and safe physical environments for children. Linking health care providers, child care providers, and families makes good sense - for maximizing resources, for developing comprehensive and coordinated services, and most important, for nurturing children.

The purpose of this Blueprint for Action is to provide communities with steps they can take to either expand existing public and private services and resources or to create new services and resources that link families, health care, and child care. Communities using the Blueprint for Action are encouraged to identify their own needs and to adapt the steps within the document as needed. The 10 steps are not prioritized; communities can determine which steps(s) should be implemented.

There are no quick and easy solutions to the challenges that families, child care providers, and health care providers face today in providing for and ensuring the healthy development of children. It is important that these three groups work together to expand and create partnerships. The Blueprint for Action will help communities as they set priorities and goals that will lead to healthier child care in America.

10 Steps that Communities Can Take
to Promote Safe and Healthy Child Care

One: Promote safe, healthy, and developmentally appropriate play environments for all children in child care.

Responsive caregiving must take place within a setting that is consistently safe and supportive. In a safe, nurturing, highly interactive setting, whether this is a family home or a center, children feel confident to fully explore and experience their environment free from injury or harm. Safe, secure transportation of children to and from the setting should also be ensured. Families should receive information about quality so they can make informed child care choices.

Two: Increase immunization rates and preventative services for children in child care settings.

Although immunizations have dramatically reduced the incidence of many infectious diseases, we have recently witnessed outbreaks of serious infection because too many of our young children have not been fully immunized. Only 53 percent of all 2-year-old children nationally have been immunized; in licensed child care facilities, however, 94 percent of the children have been immunized - demonstrating the critical contribution of child care settings as an access point for children's health services. To increase immunization rates, both families and providers should receive information on resources.

Three: Assist families in accessing key public and private health and social service programs.

Millions of young children form low-income working families lack health insurance and could benefit from assistance programs such as Medicaid and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Since children of working parents are likely to be cared for in some type of early childhood setting, child care providers can help families learn about Medicaid and WIC benefits, as well as Title V of the Social Security Act, Part H of the Individuals with Disabilities Act (IDEA), Supplemental Security Income (SSI), and other Federal and State programs.

Four: Promote and increase comprehensive access to health screenings.

Many young children have undetected health conditions that, if untreated, could result in serious injury or illness. Child care programs can provide a key access point for conducing health and dental screening, including evaluation and referrals for conditions such as lead poisoning, impaired vision or hearing, and baby bottle tooth decay. Developmental screenings are also important components of comprehensive services. Recognizing and treating potentially harmful conditions earlier rather than later is not only more effective and less costly, but can prevent future problems.

Five: Conduct health and safety education and promotion programs for children, families, and child care providers.

Promoting the safety and the healthy growth and development of our children is a responsibility shared by all. Health care and child care providers working closely together can share information and training with staff and parents on issues such as immunization, injury prevention, physical fitness, and recognition of illnesses and developmental difficulties. Child care providers, in partnership with others, can also provide information on preventing deaths and injuries caused by car crashes, drownings, fires, suffocation, poisoning, and falls. When children learn early the importance of personal hygiene practices such as brushing their teeth or washing their hands properly, and safety practices such as what to do in case of fire, these lessons can lead to good health and safety habits that last a lifetime.

Six: Strengthen and improve nutrition services in child care.

Nutrition education and health promotion programs help to inform families and providers of the nutritional needs of all young children. When young children share nourishing meals and snacks together, they grow healthier, think more clearly, explore their world eagerly, develop language and social skills, and feel comforted and cared for. The developmental, cultural, and emotional needs of children should be considered in menu planning.

Seven: Provide training and ongoing consultation to child care providers and families in the areas of social and emotional health.

Child care programs can promote healthy social and emotional development by informing and guiding child care providers and families in ways that encourage sensitive and age-appropriate care. They also can contribute to early identification and intervention with children who reflect the ill effects of exposure to violence, substance abuse, child abuse and neglect, or other emotional and behavioral problems. It is important to make more mental health services available to child care communities so that families and child care providers can take advantage of opportunities to enhance the social and emotional health of children.

Eight: Expand and provide ongoing support to child care providers and families caring for children with special health needs.

Passage of the Americans with Disabilities Act (1992) has significantly strengthened access to child care for children with special health needs or developmental disabilities. Child care providers and families need ongoing training, technical assistance, mentoring, and consultation to care for children with special needs, ranging from helping children with asthma or diabetes to assisting children in wheelchairs or those with developmental delays of disabilities. Providers and families also need information and resources concerning how the Americans with Disabilities Act will impact child care programs in areas such as inclusion of children with special needs in programs, eligibility for services, and removal of barriers in facilities.

Nine: Use child care health consultants to help develop and maintain health child care.

Health care providers can play a vital role in the training of child care staff, as well as in the licensing, monitoring, and evaluation of child care facilities. Child care health consultants can provide guidance and assistance on a range of issues affecting the health and safety of children. These can be as fundamental as helping staff determine ideal placement for eating areas and diaper changing tables in facilities, or as technical as performing onsite assessments of hygienic and safety practices and assisting in developing licensing standards. Trained child care providers who are informed about preventive health care and safety practices and resources can promote the healthy development of children and reduce illness and injury in child care settings.

Ten: Asses and promote the health, training, and work environment of child care providers.

A healthy child care setting and continuing education in the health and safety of children and staff can help providers in meeting day to day challenges. Avoiding back injury, reducing risk of infectious disease, and scheduling adequate rest breaks can enhance job satisfaction and the overall well-being of child care providers. Healthy staff provide the best care for children.

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