Child Care Programs and Medical Home
Child care programs can play a key role in the medical home and in the lives of patients and their families. A medical home is an approach to providing comprehensive primary care that facilitates partnership between patients, physicians, and families. The American Academy of Pediatrics (AAP) believes that every child deserves a medical home, where care is accessible, continuous, comprehensive, patient- and family-centered, coordinated, compassionate, and culturally effective.
The medical home model of care works to ensure that families feel supported at all stages of their child’s development. The medical home approach helps the family feel they have a partnership with the pediatrician and their practice care team related to decisions about their child’s care. A medical home can also enable improved coordination of care through activities such as development of a care plan by the pediatrician, child or youth, and family that is shared with other providers, agencies, and organizations involved with care of the patient.
A medical home also provides efficient use of limited resources and connections to information and support for patients and their families, such as:
- Opportunities for professionals to share expertise and knowledge
- Pediatricians learn about the child care group setting
- Child care providers learn about health and safety best practices
- A forum for problem solving
- Identification of community needs and strategies for addressing them.
Because child care programs frequently establish a close and open relationship with families, they are in a unique position to:
- Assist in documenting all services the child is receiving outside the of the child care center, including developing a health report in a child’s file.
- Assist families in obtaining information about resources on accessing care (i.e., Medicaid; Children’s Health Insurance Program [CHIP]; Family-to-Family Health Information Centers [F2F HICs], Women, Infants, and Children [WIC] Supplemental Nutrition Program; and other family support programs).
- Ask parents to discuss certain concerns/issues with their child’s health provider. Program staff can obtain written parental consent to exchange information with the child’s medical home to further facilitate the patient- and family-centered medical home and allow staff to talk directly with the medical home practice team for clarification about a child’s care or health needs (e.g., asthma, allergies, diabetes). If services are provided within the child care program, they can work to ensure that this information gets back to the medical home (e.g., immunizations, developmental screening, early intervention services).
It is best for a child’s health and development when families, the medical home, and child care programs work together to make sure children are healthy and safe in out-of-home child care settings. The medical home practice team (pediatrician, nurses, care coordinators) can play their part by:
- Starting the conversation and asking families age and situation specific questions such as “Who watches your baby/child for you?”, “Are you comfortable with your child care arrangements?”, and “What are your thoughts about discipline? Have you discussed these issues with your child care provider?” to begin making the link between child care programs and a child’s medical home. Through this discussion, health care providers can address any concerns the family might have about the child care setting.
- Communicating with child care programs by obtaining contact information for the program from the family and encouraging written parental consent to exchange information. Additionally, the medical home and the child care program can work in partnership to ensure children are up-to-date on immunizations and health screenings, and can assist in the completion of child care program admission forms. Medical home practice team members can work to facilitate an open relationship by contacting the child care program to introduce themselves, and providing their contact information.
A CCHC is a health care professional who has interest in and experience working with children, has knowledge of resources and regulations and is comfortable linking health resources with facilities that provide primarily education and social services. Often times, CCHCs can conduct needs assessments and trainings for child care programs related to children’s health issues.
Additionally, CCHCs can provide telephone advice and referrals to community services for parents and providers. CCHCs can be a liaison between the child care program and medical home. They can act in this capacity by promoting communication among the medical home, child care program, and family. They also can educate families and child care providers about medical home concepts and develop/implement health policies that are family-centered.
National Center for Medical Home Implementation (NCMHI)
For additional information on medical home, visit the NCMHI Web site. The NCMHI is a cooperative agreement between the Maternal and Child Health Bureau (MCHB) and the AAP with a mission to ensure that every child and youth has access to a medical home.
Healthy Child Care America (HCCA)
For additional information child care programs, visit the HCCA Web site. The HCCA program is coordinated by the AAP via its Early Education and Child Care Initiatives (the Section on Early Education and Child Care), and is partly funded by the Office of Child Care (OCC), Administration for Children and Families (ACF), and the MCHB.
- The Medical Home
To better equip health care professionals, including CCHCs, with the resources to educate colleagues and early education and child care professionals, HCCA has developed PowerPoint presentations on different topics that can be customized to meet participants' needs. This presentation will assist in educating others on what a medical home is, and how child care programs, CCHCs, pediatricians, and states can support this concept. Additional information is provided for the speaker in the "Notes" area of each presentation.
- New Bright Futures/Child Care Health Partnership Parent Handouts
These handouts program provide: tools for healthy, active living; tips by topic areas such as relationships and nutrition; and questions for parents to ask their health care professional. These tips are based in best practice, including Caring for our Children health and safety standards.
Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition
National Resource Center for Health and Safety in Child Care and Early Education (NRC) in partnership with the American Public Health Association, American Academy of Pediatrics, and Maternal and Child Health Bureau