Child Care 101: Overview and Everday Practice

The second Healthy Kids, Healthy Future Steering Committee meeting, entitled “Child Care 101: Overview and Everyday Practice,” was held on February 1. The discussion provided perspectives on the realities and current state of child care across the country.

Presenters offered an overview on a number of topics including:

• The layers of federal, state, legislative, and regulatory authority within the child care settings;
• The current state of public and private funding and potential opportunities given the released 2011 Federal Budget; and
• Perspectives from the inside of child care centers and family child care homes.

Helen Blank, Director of Leadership and Public Policy at the National Women’s Law Center, informed the group of the mixed Federal and State responsibilities for funding child care centers, the role that the Child and Adult Care Food Program(CACFP) plays in supporting the dietary needs of children in these centers, as well as the extent to which current resources are not sufficient in supporting the children who attend and staff who work at these centers.

Bob Siegal, National Director of Easter Seals Children’s Services, offered a view from inside child care centers. He explained two issues that significantly impact quality of care, whether it be family based or community based: 1) child care centers are currently overcrowded, understaffed and under-resourced and 2) providers’ income remains poor leading to frequent turnover.

Denise Dowell, Director of Early Learning and Care Programs, Civil Service Employees Association, AFSCME, presented information on the specific challenges for those who run family based child care homes. She expressed that one of the major obstacles is providing quality care for a group of children that often vary in age. A second unique challenge is the added difficulties of managing the administrative aspects of the business, including record keeping, buying/preparing foods, and providing referrals for families, while developing a child care program that supports healthy development.

The opportunity for questions and answers from the steering committee revealed a wide spread interest in the training and technical assistance available for these providers. The experts explained that training is not required in many states and that the resource and referral agencies, which are funded by the Child Development Block Grant program, struggle to provide support to many child care centers and family based care due to location and limited funding.

This meeting allowed for a better understanding of the family and community based child care perspective. With this information, steering committee members will be able to more strategically move forward with the development of agendas and work plans to address the childhood obesity in the 0-5 age range.

Childhood Obesity In the News

We are just one month into the New Year, but many exciting advancements in the childhood obesity prevention field have already occurred.

December marked the first meeting of the Healthy Kids, Healthy Future (HKHF) Steering Committee, a group of the nation’s top experts and leaders in the obesity prevention and early care fields. The members convened to discuss and establish a national action plan for moving the field forward in follow up to September’s HKHF conference. Members broke out to develop action plans in three areas: Policy, Best Practice/Tool Dissemination and Research/Monitoring/Evaluation. A second meeting of the Steering Committee, entitled “Child Care 101: Overview and Everyday Practice,” will be held on February 1. This meeting will allow experts in the child care field to present a perspective on the realities of current child care settings. Speakers will include: Helen Blank, Director of Leadership and Public Policy, National Women’s Law Center, Bob Siegel, National Director, Easter Seals Children’s Services, and Denise Dowell, Director of Strategic Campaigns, Civil Service Employees Association (CSEA), AFSCME. Updates from this meeting, as well as future forums will be posted on the www.healthykidshealthyfuture.com website.

The release of the The Surgeon General’s Vision for a Healthy and Fit Nation 2010 is an extremely exciting advancement for the obesity prevention in early care and education field. For the first time, the Surgeon General’s vision of addressing obesity includes a recommendation for “creating healthy child care settings.” She is poised to partner with the First Lady, Michelle Obama, to address the nation’s childhood obesity epidemic. (http://www.hhs.gov/news/press/2010pres/01/20100128c.html) . The Surgeon General, Regina Benjamin, M.D., urges that “child care programs should identify and implement approaches that reflect expert recommendations on physical activity, screen time limitations, good nutrition, and healthy sleep practices,” all of which were key actions at the Healthy Kids, Healthy Future conference in September 2009. Action steps to support the Surgeon General’s goal of standardizing state regulations on physical activity, nutrition and screen time, are being addressed by the HKHF Steering Committee. Through changes in policy, dissemination and implementation of best practices, and continued development of the evidence base in research, the child care environment will become a healthier place for kids to grow and develop.

For the full statement from the Surgeon General, please click HERE

***Please send us any updates from your work or additional news relevant to the Healthy Kids Healthy Future agenda of supporting obesity prevention/health promotion in early care and education settings.

Support grant program to train early care and education staff

A second piece of exciting news that we would like to pass on to you is Senator Mark Udall’s (D-CO) introduction of an amendment to the Senate health reform bill that, if passed, enacted into law and funded, would establish a grant program to train early care and education staff in best practices for obesity prevention and health promotion.  This is exactly what many of you called for at the conference!  You can support this amendment by signing on to the attached letter per the instructions below from our friends at the Trust for America’s Health (TFAH).

Senator Mark Udall’s office is planning to introduce an amendment to the health reform bill that would promote physical activity, healthy eating, and childhood obesity prevention in the very important setting of the childcare environment. The amendment would establish a three year CDC pilot program that would provide grants to five state health departments (or other childcare licensing entities within the State) to provide or contract to provide training to staff at childcare centers and family childcare homes. The training would focus on healthy eating and physical activity policies and practices that could be implemented in child care settings. Childcare centers with trained staff would then receive grant funds to implement these practice and policy changes. Best practices and lessons learned would be disseminated at the conclusion of the pilot and would be incorporated into future CDC guidance documents.

With leadership from TFAH, Nemours and others provided input to this legislation which closely mirrors the successful model Nemours Health and Prevention Services implemented in Delaware. Attached is the text of the amendment, as well as a sign on letter of support. Senator Udall’s staff has requested a Friday deadline for sign on of the letter. If you have questions or would like to sign on, please contact Daniella Gratale of Trust for America’s Health at dgratale@tfah.org.

Supporting Documents

• Support Letter
• Amendment to Health Reform Bill

Healthy Kids Healthy Future National Steering Committee To Meet Dec. 16

As we mentioned in the closing comments of the Healthy Kids Healthy Future Conference, the meeting may be over, but the real work lies ahead. As a result of your participation and collaboration, many energized and motivated attendees have continued working together to break down silos and support obesity prevention/heath promotion in early care and education settings.

As a next step to continue advancing the field, Debbie Chang of Nemours and Dr. Bill Deitz of CDC discussed forming a Healthy Kids, Healthy Future Steering Committee, intended to support continued collaboration among the field’s top leaders, and have moved forward with that. The committee will follow up on the many ideas generated at the conference to move the field forward; will continue sharing best practices and policies to encourage dissemination and adoption in the states; and will partner on other innovative strategies to improve children’s health in child care settings, including policy change and research.

At the first meeting on December 16th, the committee members will roll up their sleeves and draft a strategic plan which we will share with all of you.

Webinar to Highlight Child Care Evaluation Efforts on Dec. 10

A webinar on current quality improvements in childcare settings will be held next week on Thursday, Dec. 10 at 12 noon EST. This webinar will highlight the work of researchers in the field who are evaluating efforts to make childcare settings a place for active and healthy kids.  We hope that you will be able to join and wanted to ask if you would please spread the word to the people that you know who work in this field who would be interested in attending this webinar.

 www.reversechildhoodobesity.org/webinars.

Nemours Testifies in Support of Strengthening Child Nutrition Programs to Combat Obesity

Nemours submitted testimony to the Senate Agriculture Committee last week as part its hearing, “Reauthorization of US Child Nutrition Programs:  Opportunities to Fight Hunger and Improve Child Health.”  We agree with that the federal child nutrition programs offer a critical safety net to ensure proper nutrition in support of children’s’ healthy development. We believe that improving nutritional and physical activity standards in early care and education settings can help children and their families establish healthy habits which will last a lifetime. Nemours has developed a number of best practices and tools to encourage healthy eating and physical activity in all the places children live, learn and play, including child care settings. Our testimony, which build on our experience as a model in Delaware, can be downloaded here.

If you would like further information about Nemours’ model work to promote children’s healthy development or our stance on federal policy opportunities to do the same, contact Anne De Biasi at adebiasi@nemours.org or 202-457-1440, ext. 305.

Robert Wood Johnson Foundation Hosts Webinar on Childhood Obesity

The Robert Wood Johnson Foundation is hosting a free webinar, Let’s End the Childhood Obesity Epidemic, today at noon.

The webinar will discuss the various opportunties in implementing healthy policy changes at the federal, state and local level. Debbie Chang, vice president of policy and prevention at Nemours, is a featured speaker.

Visit the seminar site to learn more and register today!

UPDATE – Presentation from Debbie Chang and additional materials provided on Compendium Page

Photos from the Conference

View photos from the Healthy Kids Healthy Future Conference. Thanks to all the participants and speakers who attended and made it a great success. You can also view the gallery on Flickr.

AP article on the important role of child care in obesity prevention

The Associated Press recently published an article focusing on the important role child care centers play in teaching children healthy habits at a young age. It spotlights the partnership of Nemours Health and Prevention Services and the Latin American Community Center in Wilmington, DE.

Go to the article – “Day care next frontier in fighting kids’ obesity”

A Few Minutes with Dr. David Bailey, CEO of Nemours

From left to right - Dr. David Bailey, CEO of Nemours, with Dr. Bill Dietz of the CDC. Debbie Chang, VP of Policy and Prevention, Nemours, in background.

Nemours CEO David Bailey, MD, MBA, talks about why Nemours is making the investment in early childhood health promotion.

With so many other issues at stake in health care and health reform, why convene this meeting of experts on early childhood and obesity prevention?

First of all, Nemours is invested in prevention services for children.  Six years ago, we changed our mission statement to reflect the pursuit of optimal health for all children, in addition to excellence in health care and treatment. Since launching the division that focuses on population health, Nemours Health and Prevention Services, we’ve always had child care as one of four pillars of our prevention strategy.

If we can reach kids at home and in their communities, in school, in their doctor’s office, and in child care, we can provide a surround sound approach that significantly improves the chance that kids will grow up healthy.

We’ve found that when it comes to health promotion and obesity prevention, not as much attention is being paid to child care as it is to other areas, such as schools, transportation and mobility, land use, food labeling and marketing, etc.  So along with our colleagues at CDC, RWJ Foundation, and the Maternal and Child Health Bureau, we decided to create a forum where leading edge people in child care quality and obesity prevention at the state and national levels could get together and learn from each other and identify promising practices to move the field of child health promotion forward.

What was the most important outcome of this meeting?

I think the attendance and recognition by Secretary Vilsack about the importance of early nutrition and health promotion; the face-to-face dialogue among the experts; the examples of successful programs from the states that were presented; and the emphasis on health as a part of high quality child care that can be tied to states’ quality rating systems and incentives. This means setting limits and rules for foods and beverages and balancing active time and sedentary time. In other words, when child care does a good job of not only teaching, nurturing and ensuring kids’ safety, but also of addressing nutrition and fitness for young children, they should be recognized and rewarded for it.

It’s interesting that Nemours, a children’s health system based in Delaware and Florida, has this national agenda. It seems unusual – is it?

Completely. In fact, Nemours is the only children’s health network, to our knowledge, that is working to effect change at the population level and is lobbying in the interests of kids everywhere, not just their constituents. As Congress works to reform our health system, there is an opportunity to focus on wellness and establish a funding stream for disease prevention and health promotion, especially when those services are linked to traditional health care services. This ensures that the systems of care and all the practitioners who care for children are coordinated in supporting the health of kids and their families. Nemours is a pioneering example of an integrated health care organization that links community-based prevention with clinical care.