Providing Child Care for Mildly Ill Children

Sick child care programs provide care for children who are mildly ill or recovering from a health problem. In most states, Wisconsin included, ill children are not allowed to attend regular child care programs. Several program models for the care of sick children have developed across the country in recent years. Although programs for sick children may not serve parents for all the days a child is sick, they can provide an alternative for days when a child is mildly ill. Almost all models exclude children with a high fever or serious illness, and most group programs exclude children with infectious diarrhea and highly contagious diseases such as chicken pox. (In Wisconsin, children with infectious diarrhea and highly contagious diseases such as chicken pox must be excluded from child care.)

The various models of sick child care include: (1) a center that cares only for sick children, (2) a program within a hospital, (3) care in a "sick bay" at a regular child care center, (4) a family day care home, and (5) in-home care or visiting nurse service. Programs vary on what childhood illness or symptoms of illnesses they will admit or exclude from a program. (Wisconsin centers must comply with the Department of Health Communicable Disease Chart.)

Factors distinguishing programs for mildly ill children:

Sanitation policies and procedures should be more stringent

The ratios of caregivers to children should be higher than in well care

Providers should be trained in caring for ill children (these children may need to rest and may have restrictions on the activities in which they can be engaged)

Record keeping procedures are more complex. When a child arrives, a health check should be conducted by the provider with the parents; the health check serves as a screening for exclusion purposes and gives information to be used in providing appropriate care to the child.

Center-based programs are similar to those of regular child care centers. An entire center may be developed solely as a sick care program, or a sick care program may be a part of a regular center. The latter is called a sick bay and consists of rooms in a regular center set up to care for ill children. Children who are excluded from the center because of illness may be moved into the sick bay. (Wisconsin requires that illness be non-contagious.)

Family day care sick child care programs operate similarly to regular family day care.

Hospital-based programs usually operate independently from the pediatric ward of the hospital.

(Wisconsin Group Day Care Rules: The room must have sink with hot/cold running water that is not used for food preparation.)

Disadvantages to providing child care for mildly ill children:

Monitoring quality control may be more difficult

Recruiting/retaining qualified staff may be more difficult

Usage may be low due to the unfamiliarity of parents to the concept of child care programs for mildly ill children

Caregiver/surroundings may be unfamiliar to the child

Advantages to providing child care for mildly ill children:

Enhance marketability of child care program

Reduces absenteeism, relieves stress on parents

Steps in developing a sick child care program

Conduct a needs assessment of parents using your program, and others in the community

Determine what sick child care programs exist in the community (A small percentage of parents use the program in the beginning. Repeat usage is high and additional parents use the service because of user recommendation. Your local Child Care Resource and Referral Agency (CCR&R) will be helpful in determining the existence of programs in the community.)

Determine licensing requirements

Determine specific location of the program

Determine staffing arrangements

Purchase materials and equipment

Recruit parents to pre-register for the program

Determine program features:

Exclusion policies on what childhood illnesses will be admitted or excluded

Infection control procedures

Curriculum of activities for ill children

Staff training on childhood illnesses and in caring for ill children, including:

Sanitation practices

Giving medications

Taking temperatures

Record keeping

Make financial projections

Plan the marketing strategy

Develop an evaluation mechanism to evaluate the adequacy and usefulness of the program. An evaluation may include:

Monthly review of budget versus cost reports

Usage figures

Quality control standards

Annual program review

Technical assistance needed (A health consultant should assist in developing the policies and procedures. A health consultant can be a health care professional who works for the local health department, a physician, or a nurse practitioner or registered nurse.)

Wisconsin resources:

To learn if such programs exist in your area, and to find out if employers have requested such services, contact your local Child Care Resource and Referral (CCR&R) agency:
Phone: 888-713-KIDS (5437)
Email: wiccrr@athenet.net
Web: www.wisconsinccrr.org

To obtain videos, books and other resources, including the Division of Health Communicable Disease Chart contact:
Wisconsin Child Care Information Center (CCIC)
Phone: 608-224-5388 Phone: 800-362-7353
Email: ccic@dpi.state.wi.us
Web: www.dpi.state.wi.us/ccic

To receive copies of other "Best Practices" tip sheets and other information on the many aspects of regulated child care, contact
Wisconsin Child Care Improvement Project (WCCIP)
Phone: 800-366-3556
Web: www.wccip.org
The WCCIP Infoline is staffed 9:00 a.m. to 4:00 p.m. weekdays

To obtain a copy of Wisconsin Licensing Rules for Group or Family Day Care centers, contact your nearest regional licensing office or visit: www.dhfs.state.wi.us

Northern Regional Licensing Office
P.O. Box 697, 1853 Stevens St.
Rhinelander, WI 54501
Phone: 715-365-2500

Northeastern Regional Licensing Office
200 N. Jefferson St. Ste. 411
Green Bay, WI 54301
Phone: 920-448-5312

Southern Regional Licensing Office
2917 International Ln. Ste. 110
Madison, WI 53704
Phone: 608-243-2400

Southeastern Regional Licensing Office
141 NW Barstow, Room 209
Waukesha, WI 53188-3789
Phone: 414-521-5100

Western Regional Licensing Office
610 Gibson St., Suite 2
Eau Claire, WI 54701
Phone: 715-836-2157

Reprinted with permission from the
National Network for Child Care - NNCC
Beierlein, J.G., & Van Horn, J.E. (1991)
Child Care Options for the 90s
University Park, PA: Penn State University

WCCIP • 2109 S. Stoughton Road, Madison WI 53716 • Ph 800.366.3556 • Fx 608.224.6178
These tip sheets developed by WCCIP, March 1998 with funding from the WI Dept. of WFD, Office of Child Care, and DHFS

Providing Child Care for Mildly Ill Children James G. Beierlein/James E. Van Horn Better Kid Care Project, Penn State University

Providing Child Care for
Mildly Ill Children
James G. Beierlein/James E. Van Horn
Better Kid Care Project, Penn State University