NC CCHC Service Model

CCHCs are health professionals with education and experience in early childhood health and safety. Active CCHCs successfully completed the NC Child Care Health Consultant Course and stay up-to-date on CCHC practice by meeting the CCHC Standards of Practice. On the North Carolina Child Care Health and Safety Resource Center website, the Find a CCHC page has a registry of Active CCHCs. The registry includes the CCHC’s name, contact information, agency, and type of support.

NC Child Care Health Consultant Certification and Technical Assistance (TA) Endorsement

Active CCHCs submit an application for CCHC Certification/TA Endorsement (CCHC C/E) if they:

• have completed at least 1,000 hours of CCHC work from when they completed the CCHC Course
• are maintaining their Active CCHC status and meet the NC CCHC Standards of Practice
• are a member of the NC CCHC Association

Information and requirements for CCHC C/E are available on the NC Child Care Health Consultant Association and NC Institute for Child Development Professionals websites.

The essential functions of a CCHC are described in the National Center on Early Childhood Health and Wellness Child Care Health Consultant Competencies. The CCHC Competencies and the NC CCHC Service Model guide the daily activities of the CCHC. The CCHC Competencies fall into two categories:

• General areas: which apply to the work of the CCHC across all topic areas
• Subject matter areas: which are specific to the core content areas of health, safety, and wellness

Each area includes three sections:

• the competency: what a CCHC should be able to do to perform effectively within that focus area
• the description: knowledge and skills related to each competency
• the application: activities a CCHC may perform to demonstrate the competency

While a CCHC is not expected to be an expert in every focus area, CCHCs are expected to identify local resources and/or community partners with the knowledge/skills needed for collaboration. A Training and TA Decision Tree is available in the CCHC Program Manual to help guide these decisions. CCHCs work with their direct and programmatic supervisors and their CCHC Implementation Specialist to increase their knowledge and skills around all areas of focus throughout their time working as a CCHC.

CCHCs work collaboratively with a regional CCHC Implementation Specialist and their hiring and funding agencies to develop and document goals based on the priorities of the community served, the needs of the ECE programs, and capacity of the CCHC program. CCHCs work with the State Child Care Nurse Consultant to identify local public health priorities.

CCHCs work primarily with early educators in ECE programs that are regulated by the Division of Early Care and Education (DCDEE). CCHCs may also provide services to programs that are exempt from regulation.

Caring for Our Children: National Health and Safety Performance Standards recommend that the CCHC, “should visit each facility as needed to review and give advice on the facility’s health component and review the overall health status of the children and staff.” The frequency of visits should meet the needs of the children and be based on the needs of the ECE program for training, support, and monitoring of child health and safety needs.

CCHCs work to achieve high-quality, safe, and healthy ECE environments in the focus areas defined by the National Child Care Health Consultant Competencies through:

• outreach and collaboration with regulatory agencies and community partners
• engaging in quality improvement processes with early educators including assessment, planning, implementation, and evaluation
• providing training and technical assistance (TA) through coaching and consultation to early educators as defined in the Early Childhood Education Professional Development: Training and Technical Assistance Glossary. Training and TA may be provided face-to-face (preferred) or through phone, virtual, or hybrid methods.

For CCHCs, coaching consists of engaging early educators in a Quality Improvement Cycle using the NC Health and Safety Assessment and Encounter Tool (HSAET) as described below. Consultation involves an encounter with an early educator(s) to address a specific concern or set of concerns with at least one additional encounter to follow-up on consultation given.

If a CCHC provides consultation to early educators in an ECE program on a regular basis, consultation will ideally transition to a coaching relationship.

The process of child care health consultation includes the implementation of a quality improvement cycle in the child care setting.

Building Relationships

CCHCs build and maintain relationships with early educators, community partners including regulatory agencies, local technical assistance providers, local health department contacts, and other CCHCs. ECE programs play an active role in determining how they engage with a Child Care Health Consultant and what level of support they require.

Initial assessments

CCHCs assess the knowledge and behavior of early educators and the indoor and outdoor environments of ECE programs using the NC Health and Safety Assessment tool. Assessment includes on-site observation, conversations with early educators, reviewing forms, documents, and policies, and identifying unmet health and safety needs. Assessments are conducted in a classroom or other appropriate areas of the ECE program such as a kitchen, playground, or where paperwork is stored.

Quality Improvement Planning

Quality improvement (QI) planning is a joint effort between the CCHC and the ECE program. CCHCs support early educators in prioritizing areas needing improvement and developing strategies for implementing changes to health, safety, and wellness practices. CCHCs provide guidance to ensure changes align with federal and state regulations, state quality rating and improvement systems, and best practice standards, such as accreditation requirements and Caring for Our Children.

Implementation of Strategies

CCHCs support early educators in implementing the strategies identified in the QI planning process through a series of encounters. For example, by providing training or technical assistance, developing and implementing a new policy, behavior change, or environment modification.

Follow-Up Assessment

After implementation of the quality improvement strategies, a follow-up health and safety assessment is completed on the areas chosen for quality improvement. This is an opportunity to evaluate whether areas identified as needing intervention were comprehensively addressed with sustainable outcomes.

The NC HSAET is an online tool that CCHCs use to collect data related to the Quality Improvement Cycle and any other encounters they have with ECE programs. More information on the NC HSAET can be found at: NC Health and Safety Assessment and Encounter Tool

The NC CCHC Service Model was initially developed in December 2013 by:

The NC CCHC Service Model is aligned with:

• National Center on Early Childhood Health and Wellness’s Child Care Health Consultant Competencies.
• Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs