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The Child Care Nurse Consultant (CCNC) is contracted with two agencies: Crawford

County Home Health, Hospice & Public Health and Calhoun County Public Health. This

year a minimum number of site visits was added to the Deliverables in the Contract. Which

is 50 annually, per contract. Crawford County (Chris Lee) had 14 on site visits, Calhoun Co

(Deb Gimer) had 9 on site visits. CCHHH&PH is working with 11 programs; 7 registered

and 4 DHS Licensed, CCPH is working with 15 programs 9 registered and 6 DHS Licensed.

The CCNC is a funded at a part-time status around .28 FTE.

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CCHHH&PH (Chris Lee) # TA Contacts = 21 CCPH (Deb Gimer) # TA Contacts = 49. Technical

Assistance can mean anything from phone conversations, to an exchange of information is emails.

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Chris Lee is currently working with a church preschool on their Injury Prevention assessment. A

Home provider on Medication Administration Competency test. Introduction with new Director at

Children's Imagination Station, and technical assistance on a child’s illness. Contacting new

providers, some have decided not to provide child care. Spoke with a person on the board to set up a

center in Manilla. Visit set to talk with new day care supervisor at Beyond Dreams.

Deb Gimer has had multiple issues this quarter with infection diseases. Worked with programs on

cleaning, sanitizing, and disinfecting for prevention of infectious disease spread.

Due to funding from the Early Childhood funding silo, the CCNC only work with Child Care Home,

Licensed Centers.

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Another duty of the CCNC is to work with children with special/health needs. They help develop

care plans for the child care provider/center to have in place. Calhoun County reports having seven

(7) in place.

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In addition to visits with child care providers, the consultant completed trainings and participated in coalition

activities.

• Playground Safety at University of Northern Iowa

• Adult Learning Styles in Wall Lake

• Mid-Sioux agency meeting - Iowa & Positive Behavior Initiative Support planning meetings

• Assisted the Crawford County Coalition, volunteered to assist with DR ALTO at AG Days

• Ready Set Grow Board meeting to discuss expansion at Methodist Manor in Storm Lake

• Coordinated Intake meeting representing Crawford County

• Watched webinar on new nicotine regulations for child care homes and centers

• Technology training for the i-pad and moving technology forward

• Renewed Mandatory Child Abuse certification and Universal Precautions

• Attended county coalition and 3-county board meetings.

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This first Quarter brought milestones for some of the providers working with the consultant.

• Assisted two (2) providers in completing their Child Net recertification.

• Two (2) providers are having the Environmental Rating Scale assessment from Iowa State University in

order to achieve a 5 star on the Quality Rating Scale, and several more are working on their quality

initiates.

• In one particular situation a registered provider called Retta and was going to let her registration lapse

because she didn’t want to do night trainings. Retta understood her situation at this time (a broken foot) so

she encouraged her to look at on-line trainings. She stated her internet was terrible and didn’t know if it

would work. Retta left her that day with the idea, and what she could do. When Retta called her back a

couple days later, she had received a call from another provider asking her to go tot the training with her

and a niece and assured her she would help her get on line for the webinars. I was able to send information

about both trainings to her and she is going to attend and continue registration.

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Child Net initiative started this Fiscal Year is to provide an incentive for those providers that

received their Child Net Certification. Each provider that receives their certification will receive a

tote bag full of resources they can use in their programs.

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The BVCS ECI 3-County Board contracts with Crawford County Home Health, Hospice & Public Health

(CCHHH&PH) and Webster County Health Department (for BV & Sac counties) to provide the services.

Crawford Deliverable to serve 150 children. BV & Sac Deliverable to serve 200 children

Webster County: Head Start consent forms were sent home to all children enrolled in Head Start in BV & Sac

Counties. Dental screening and fluoride varnish applications, along with oral health education, were provided

to all children with signed returned consent forms. Parent letters were sent home to the parents for all children

to notify parent screenings and fluoride varnish applications were completed and any findings. Care

coordination has been provided to all children with indicated possible dental needs. Parents were offered

assistance in finding a dental home, assistance with scheduling appointments, financial assistance if needed

transportation. Two phone call attempts were made to contact parents and a follow up postcard mailed, when

contact was not successful. Head Start staff were very accommodating and easy to work with. Webster

County is paid on a $50.00 per child cost. Billing is processed through Title 19 first, if the claim is denied, it is

then bill to BVCS ECI. The BVCS ECI Director will contact the contractor to make sure the for the total

number served by age is counted, reported number was not by age group.

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Newspaper article place in the Fort Dodge Messenger, The Pilot Tribune, Ad Guide, and Northwest Iowa

Shopper.

CCHHH&PH also sent an article to local newspapers. Here is the Content:

Teething and Tooth Eruption

Tooth Eruption

A baby’s teeth begin to erupt at about 6 months of age. The lower front teeth are usually first, followed by the

upper front teeth. By age 2 to 2½, most children have all 20 primary (baby) teeth. Permanent teeth begin to

erupt at ages 6 to 7 years old. The lower front teeth and the first molars are usually the first permanent teeth to

erupt.

Teething Symptoms

Your child may have sore gums when teeth erupt. Normal symptoms of teething include:

• Drooling more than usual

• Fussy behavior

• Crying

• Not sleeping well

• Loss of appetite

Diarrhea, rashes, or a fever over 100 degrees are NOT normal for a teething baby. If your baby has any of

these symptoms while teething or continues to be fussy, call your physician.

Teething Do’s and Don’ts

DO gently rub your child’s gums with a clean finger or something cool like a small spoon or a wet washcloth.

DO use solid teething rings.

Do NOT use a plastic teething ring with liquid filling. Your child could chew through the plastic.

Do NOT use teething biscuits. The biscuits can increase your child’s risk for tooth decay.

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Do NOT use a medicine for your child’s gums without the advice of your dentist or doctor.

For more information on oral health, you can contact your local dental office or your I-Smile™ Coordinator

Jennifer Macke, RDH at 712-263-3303, or visit http://ismile.idph.iowa.gov/. The I-Smile Program provides

oral health education, oral screening, fluoride varnish, and care coordination services for children in Harrison,

Cass, Crawford, Monona, and Shelby Counties.

Oral health services are funded by the Iowa Department of Public Health, Buena Vista-Crawford-Sac Early

Childhood Iowa, Harrison-Monona-Shelby Early Childhood Iowa and Boost4Families Early Childhood Iowa

(Cass-Mills-Montgomery)

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First Quarter Numbers children by County: First Quarter Families by County: First Quarter Home Visits by County:

Buena Vista -50 Buena Vista -40 Buena Vista- 172

Crawford – 66 Crawford –44 Crawford - 199

Sac - 29 Sac – 19 Sac – 99

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Crawford Story:

-EP was one of the client’s that were enrolled in the Family STPES program during this quarter. The family was admitted

on 3/7/17 for parent support and education for their daughter Violet. Prior to admitting EP on Family STEPS Staci Gallup

with Northwest AEA was involved with the family due to the doctors concern that the child was not communicating as she

should. During AEA’s assessment Staci noted that Violet was not delayed enough to enroll her into the program. Staci did

note that the parents needed some education information on ways to encourage Violets developmental milestones. This is

when Staci with AEA referred the family to Family STEPS. On admission EP noted that they wanted Violet to be able to

start school in the fall but, were they were concerned because she was not yet potty trained. A few of the other goals that

the family wanted to work on was weaning Violet off of the breast, having her sleep in her own bed and being able to

separate from Mom without the anxiety and tantrums that occur when Mom leaves the room. From March 7-August 30 the

family completed all of their goals that they had set for themselves. There were many obstacles that came up during this

time and one of the big ones was the FOB becoming injured and unable to work, which caused major stress with paying the

bills. There were also medical concerns with Violet relating to seizers that she was having. So, there were many trips to

Omaha Children’s Hospital for treatment and follow up. We were all relieved to find out that the seizures that Violet was

having were not actual seizures and the Dr.’s were not worried about ongoing problems with them. Through it all EP

remained very positive and focused on her family and their needs. The family completed the Family STEPS program on

8/30/2017. I contacted EP on 9/29/17 per discharge policy to follow up and see how the family has been doing since

discharge. EP verbalizes “Everything is going very well. Violet loves school. FOB had surgery 2 weeks ago and is doing

much better.” Mom then tells FSW that Violet is sleeping in her own bed all night long. “Amy, thank you so much for

everything you did for us. We love you and miss you very much.”

*Because of the funds through ECI, Family Support Workers are able to provide the services these families need. And,

because of that, families have the success they need to continue to move forward. Thank you ECI!!

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Crawford County Family STEPS Marketing - Recruitment

7/17/17-Crawford County Family STEPS met with LSI (Lutheran Services of Iowa) regarding their

services and provided them with brochures about the FS program.

8/16/17-Crawford County Family STEPS met with the new Head Start/Early Head Start Family

Advocates and shared information on programs.

8/29/17-Crawford County Family STEPS visited with Plains Area Mental Health in regards to the FS

program.

9/16/17-Assisted with a Car Seat Safety event in Carroll Ia. from 9-1 at the Carroll County Court

House.

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Sac County Family STEPS:

Family STEPS was recently awarded our re-credential by the state. Our review was held in June and we were

notified of our achievement in July.

A two year old child I see was referred to AEA by our program a few months ago for developmental delays, particularly in

speech. Although the family was reluctant, they agreed to meeting with the speech therapist from AEA an average of 1-2

times per month. During this time, the parents were encouraged to use sign language with their daughter to help her learn

to communicate as she was not verbal. The parents started out with just two signs, one for "me/mine" and one for "more."

Within just a week, the two year old was using the simple signs at least part of the time. I used these signs also during our

visits. Mom was even more overjoyed to tell me that her one year old son is also starting to use sign language to

communicate. Although he is not delayed in any area, he sees his family communicating with each other using a few

simple signs so has started to do the same. He will even use the words associated with the sign "me/mine". Mom was so

excited and shared a video with me of him using the signs. This seemed to be a big step in building trust between not only

me and the family, but also with the family and AEA staff. Mom continues to regularly use sign with her daughter and son

and has expanded to at least four signs. Both of the children's self confidence has shown through in seeing mom's reaction

to their achievements. Mom's self esteem has increased over the last few months since participating in STEPS and is more

willing to try suggestions given during visits.

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Sac County Marketing - Recruitment

I have started Sac County Family STEPS Facebook page where families I currently work with,

families I have worked with in the past or anyone interested can "Like" and see content. On this

page, I explain what the Family STEPS program is for anyone that may be interested in services or

who knows someone that could benefit from the program. I post community (local and county)

family friendly activities on this page as well as helpful parenting articles, resources and words of

encouragement.

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Buena Vista County Family STEPS

Visit:

During a home visit FSW did an ASQ. The child scored low. FSW made referral to AEA. AEA now

in home with speech and occupational therapy. AEA concerned about possible Autism in child.

Success:

• We successfully got re-credentialed.

• One of FSW’s mom’s left her verbally abusive husband. She is working on getting her GED now.

• We have a couple families in ESL classes and one getting her CNA.

Challenges/Barriers:

• Dr. changes for the families. Random changes on families insurance cards and having to call to

help change the provider on the cards.

• FSW has 3 hard DHS cases right now.

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Buena Vista County Family STEPS

Public relations activity: 8/7/17 Article in paper talking about getting re-credentialed.

The Family STEPS program in Buena Vista, Crawford and Sac Counties received the Family Support Credential.

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In the first quarter $53,315.00 have been allocated for preschool scholarships. 5.9% of the funds are still available.

Parents expressed their appreciation with the change to allow for the Statewide Voluntary Preschools charging tuition or a wrap around program to be able to participate.

There is one preschool in which a child qualified for a scholarship, but the child is currently on a waiting list for the program.

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16.3% did not graduate high school27% completed high school 32.7 completed a trade/voc training and/or 2 years of college23.6% completed 4 year college/ bachelors

58.8% are married.

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10.9% of the families are under 100% of the Federal Poverty Level.

32.7% of the families are between 101% and 150%

32.7% of the families are between 151% and 200%

3.63% of the families are between 201% and 299%

20% of the families are between 299% and 300%

Majority of families receiving scholarships are white. Preschool offer assistance to the families in the

completion of the application.

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