AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
MARY BETH JACKSON: Good morning. In the essence of time, I want to, you should have a handout if you picked it up in the back or it was on your table. It's got the yellow piece of paper on the front. I sort of wanted to go through the handout first just in case I don't have time at the end to sort of explain why I put these particular items in the handout. Today I'm going to be talking to you about three programs that are located within the department for public health in Kentucky. I just wanted to give you the yellow sheet at the top to just kind of help you understand that the three programs that I'm going to talk to you about today are just a part of Kentucky's overall system for early childhood. And the listing is front and back, and it just kind of goes through the programs that Kentucky has implemented in their early childhood system. It was implemented in 2000. All the programs did not roll out at the same time. In fact, the early childhood mental health program, which is one of the programs I'm going to talk about today, was one of the final programs to roll out of this initiative. And we're three years out in it now. So it was ‑‑ it was about a two‑year process to kind of get all these programs up and running. But also if you're looking, the main reason for giving you this is if you're looking at certain programs in your state and you happen to see one of them on this sheet, there's contact information, and anyone in the state would be happy to give you more information on the particular programs.
The second piece of the handout is a PowerPoint handout, and it is not the same PowerPoint that I'm going to be providing today. The reason being is this is a little bit more in depth information. Since I'm covering three programs in a small amount of time I'm not going to be able to get into some real logistical type components of the programs. So this goes into a little bit more detail. And what this handout does include is Internet websites and contact information on the specific programs if you'd like more information on any one of the three. Of course I'll be happy to answer questions after the presentation if you have specific questions as well.
The third piece of paper, the green colored one, is simply the early childhood mental health program goals. We had to bring a large group of stakeholders in just to develop what we wanted for the children in the state as far as its early childhood mental health program. That helped drive our efforts and our development of the program.
The next sheet was actually developed by a local private agency, advocacy group in Kentucky, and I wanted to share this with you, because the primary population that this was developed for is the physicians and pediatricians in the state, because they have ongoingly told us at the state that they don't know exactly what resources are out there when they do have parents that come in with concerns about their children's behavior or social emotional health. And so Kentucky Child Now is actually the group that developed this. And this is a flow chart. They actually piloted it in the state about a year ago. It's a lot larger than what you're seeing and it was laminated. And on the back of it, they included, when they passed it out to the offices, they actually filled in the information for them. So the Head Start coordinator they had the contact information filled in for them the Healthy Start consultant and so forth. Basically what it is if you can look at the front, if a child comes in for a well child visit and the parent expresses concerns, the doctor can refer to this tool and start at the top and just ask if the child is currently in a structured program. If yes, you can see the abundance of programs that are available. And if no, there's a procedure and a system in place. And this just kind of helps the provider, because what I have found, when you're in the early childhood field, and you say early care in education and then you mention Head Start, those are two very different programs, two very different terms in our world. But if you go into the medical world, or into the mental health world, it's all day‑care. You know, there's no specification. So this helps the physicians and so forth understand that there are different programs within the birth to five age range.
And, of course, the final one is just a tool that we have passed out to child care centers in the state and posed in a bulletin board in various referral agencies in the health departments, doctors' offices and so forth, just letting the state know that there's a new program in place. We're new, we're learning but we're out there and call us if you have any concerns.
So if you have any questions as you're looking through that I'll be happy to answer them at the end of the session or there's contact information. I believe I've included my business card. So you're welcome ‑‑ I would welcome any phone calls or emails or whatnot. I'm just really happy to help in any way I can especially if you're at the beginning of this. And just starting it.
What I'm going to talk about today are three programs and specifically I know Michael sort of kind of told you a little bit about my background, but I'm the early childhood mental health program administrator in the state but I also serve in a different capacity. I'm within the early childhood promotion section in Kentucky's public health system. A couple years ago we inherited our Part C program in public health. It's been kind of passed around from agency to agency, and I see you all can relate. And so with that we realized that our early childhood programs were growing rapidly, and it was a huge burden on the maternal and child health branch. So we did split ‑‑ we're in the same area, but we do have a new branch called early childhood development. Within the early childhood development branch, we've got a promotion section or prevention, and then we've got our intervention. So we've kind of ‑‑ I think it's a really good setup so far it's working well on how we've divided that out.
Within our promotion/prevention section, these are three programs we've got. And like I said earlier I'm not going to go into specific details. Our Hands program is our visiting program and you've heard about home visiting there's a home visiting session going on right now and we'll be happy to give you more information. But I want to share with you how we recommend bedding our social emotional piece into that program.
Just having early childhood mental health program is a great thing, but it's important to embed those principles into all the programs. So what Hands is doing is they're using the Ages and Stages questionnaire, and they're screening these children and if they do in fact, are identified with a social emotional concern, then they will refer to the early childhood mental health program. And there is someone within that program who can meet that family's needs in some way, shape or form.
The Healthy Start and child care program, I do want to say it's the same program that Erica and Michael, it's the same name, but I want to clarify, it is a totally different program. Our Healthy Start program is a nurse consultant program in child care centers, that's just the name we have for it. Our Healthy Start and child care program has got roughly about 88 Healthy Start consultants across the state and they're located in the hell departments. What they do is provide health, safety, nutrition, consultation and education to early care and education providers.
This is in the form of trainings, they will actually go out to the centers and do a consultation, do a hand washing exercise what not with the child care centers. They're very available. I've got my own experience with the Healthy Start program, and when I was directing a mom came in said her child had been, she just came from the doctor and he had scabies, being a director dealing with staff turnover and mad staff and kids sick and just running around the program I didn't know anything about this and I did call the Healthy Start program and probably within the hour she came to my center with a three‑ring binder with parent notes how to clean the center. It's just a really good program as far as understanding the needs of the child care center directors and staff and how busy they really are and don't have the time to invest in those health and safety issues that we all know they need to be looking at on a regular basis.
What the Healthy Start program also does is provide training and education on the emotional social health of young children. They have access to the Devroe Early Childhood Assessment, the DECA what they do is educate the childhood centers on how they may use the DECA in their program curriculum and in their approaches to develop and ensure healthy social emotional development for the children.
When the early childhood mental health program in Kentucky rolled out, we realized that the number of referrals that we may get as a result of this program may be overwhelming at first. So using the Healthy Start and child care program to embed the social emotional skills in what they already do is providing a more universal approach and a preventive approach. That was our goal. I will talk to you later about as the program has rolled out what it's turned out to be is the child care centers have needed this type of a setup for so long that the Healthy Start consultants are not getting calls from directors saying: Oh, we'd like you to come in and give our staff strategies on promoting social emotional wellness. They're calling our Healthy Start consultants and saying: I'm kicking Johnny out tomorrow. It is very much a crisis situation. We are hoping with the education and with the growth of the program it will become more of a universal approach. But right now we are definitely just meeting the basic needs so that these children are not getting kicked out and expelled from child care centers.
And then with that information I'm going to go into the early childhood mental health program. It provides mental health consultation assessment and therapeutic services for young children and families.
We currently have 14 specialists across the state. That's not many. You know for a large state. But we have to start somewhere. And you'll see as I go through the slides how we are trying to build capacity with those 14 specialists. So it's going to grow.
These are the tools, screening and assessment tools that we're currently using within public health to encourage the social and build the social emotional development piece. Of course like I mentioned before the home visiting Hands program uses the Ages and Stages questionnaire. They also, if you'll look in your handouts, there's a slide in that in the PowerPoint handout that's more in depth about what the home visit is about. It's on the second page. And the curriculum that our home visitors are using is a parent/child interaction curriculum. And it looks at attachment bonding and care giving. It also deals with the social emotional development and recognizing cues and communication. And so embedded within the home visiting curriculum is a lot of social emotional building pieces that we hope again will build that universal approach within the state. And again there's the Devroe early childhood assessment which the child care healthcare consultants, I don't want to confuse you because they're two names we're using today, they are using those tools. It's a really quick little, if you're familiar with this tool, it's about 20 something questions. They hand those out, allow a teacher and a parent, either/or, to fill them out and then the Healthy Start consultant collects those, scores them and facilitates a meeting with the parent and director. And whoever else the director may want to include on the meeting.
I do want to give you a little bit of information, when we first rolled this piece into Healthy Start program, a lot of our, the majority of them are nurses, or health educators within the health departments, and there was a real hesitancy from them for liability reasons, you know, we're diagnosing these kids by doing the social emotional. This isn't our field. This is for the mental health people. The DECA can be done and scored, used by anyone. And that's the beauty of this tool. And what we've kind of ‑‑ the approach we've taken is, you know, if you take someone's temperature in a clinic visit and they have a fever of 102 are you going to say you have a fever of 102 and I think it means you have the flu? You're simply going to state: You have a fever of 102. With the DECA assessment, we've just told the Healthy Start consultants: Let them know you have scored....