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TA Consultation and Coaching: Child Care Health Consultant (CCHC)

Category

Early Care and Education

Child's Age

0-1 years, 1-2 years, 2-3 years, 3-4 years, 4-5 years

Participant

ECE Teachers

Languages

English

Brief Description

Child Care Health Consultants are trained health professionals who work with teachers and administrators to assess, plan, implement, and evaluate strategies to achieve high quality, safe and healthy child care environments. Technical Assistance is the provision of targeted and customized supports by a professional(s) with subject matter and adult learning knowledge and skills to develop or strengthen processes, knowledge application, or implementation of services by recipients. Consultation is a collaborative, problem-solving process between an external consultant with specific expertise and adult learning knowledge and skills and an individual or group from one program or organization. Consultation facilitates the assessment and resolution of an issue-specific concern—a program-/organizational-, staff-, or child-/family-related issue—or addresses a specific topic. Coaching is a relationship-based process led by an expert with specialized and adult learning knowledge and skills, who often serves in a different professional role than the recipient(s). Coaching is designed to build capacity for specific professional dispositions, skills, and behaviors and is focused on goal-setting and achievement for an individual or group.

Expected Impact

  • Increase in the number and quality of written health and safety policies and standards in childcare centers
  • Improved staff competencies and compliance related to health and safety standards   
  • Improved child health (e.g., increased immunizations, health coverage, decrease in upper respiratory illness and accidental injury rates)

Core Components for Model Fidelity

  • North Carolina CCHC Service Model: Services that are provided using Smart Start dollars in this activity include: 
    • Technical assistance: Technical assistance (in the form of coaching and modeling) provided to early childhood educators working in licensed and/or G.S. 110 child care facilities serving children birth to five years old to identify and promote healthy and safe environments for children in child care settings. 
    • Training for child care providers: Training for DCDEE credit hours provided on health and safety education related topics and coordination of CEU opportunities. 
  • North Carolina CCHC Health and Safety Assessment and Encounter Tool (NC HSAET): A Child Care Health Consultant (CCHC) will use the North Carolina Child Care Health and Safety Assessment and Encounter Tool (NC HSAET) to enter all consultation and coaching with early care and education programs as encounters and conduct assessments in classrooms or other ECE areas (for example, kitchen or outdoor learning environment) and develop a quality improvement plan, informing technical assistance and training. Documentation is maintained for all technical assistance and training. 
  • Child Care Health Consultant (CCHC): A CCHC is a health professional who works in partnership with early educators and child care facility staff to promote healthy and safe environments for children in child care. CCHCs provide training and technical assistance to childcare providers and assess child care environments and practices in the following health and safety areas:  
    • Illness and Infectious Diseases 
    • Children with Special Health Care Needs 
    • Medication Administration 
    • Safety and Injury Prevention 
    • Emergency Preparedness, Response, and Recovery 
    • Infant and Child Social and 
    • Emotional Wellbeing 
    • Child Abuse and Neglect 
    • Nutrition and Physical Activity 
    • Oral Health 
    • Environmental Health 
    • Staff Health and Wellness 
    • Additional support provided by CCHCs include guidance on:  
      • Policy Development and Implementation 
      • Health Education 
      • Resource and Referral

Languages Materials are Available in

English

Delivery Mode

Consultation is provided by a CCHC within the childcare facility. There is a strong preference for in-person consultation and coaching, but hybrid options are a reasonable response to environmental factors.

Dosage

Consultation Visits: National best practice standards recommend that facilities receive a regular consultation visit according to the following schedule:  

  • Facilities that serve infants and toddlers should be visited at least once a month. 
  • Facilities that serve children three to five years of age should be visited at least quarterly (4x/year).  

CCHCs should also identify and prioritize programs that require more support such as those who serve children:  

  • with special health care needs  
  • who are homeless  
  • who are at risk of or exposed to maltreatment  
  • who are living with toxic stress

Infrastructure for Implementation

Materials: Encounter Tool

Space: A quiet meeting space that supports conversation is recommended. CCHCs can also be home based or have an office at their hiring agency. CCHCs require space to store materials for technical assistance and training.

Staffing Requirements

The Child Care Health Consultant (CCHC) is a Registered Nurse with a Degree in Nursing (ASN or BSN) or a health professional with a minimum of a Bachelor’s Degree in health education or a health-related field. The health professional is or will become a qualified CCHC in North Carolina through the completion of the NC Child Care Health Consultant Training Course and receipt of a certificate of qualification, known as the Child Care Health Consultant and Technical Assistance Endorsement. Qualified CCHCs must have successfully completed the 12-week NC CCHC Course.

Requirements for acceptance into the NC CCHC Course: 

  • Current job responsibilities that include providing child care health consultation services as outlined in the CCHC Program Manual
  • Experience in or knowledge of the following areas:
    • Pediatric health
    • Community health
    • Health education
    • Early care and education
  • Be one of the following:
    • A licensed health care professional: includes a registered nurse, physician, nurse practitioner, physician assistant, or paramedic with an active license that is unencumbered in the state where CCHC services are provided.
    • A health educator with either a minimum of: 
      • A bachelor’s degree from a four-year college/university with a major in health education or related field such as community health or health promotion. Certified Health Education Specialist (CHES) designation preferred. 
      • A bachelor’s degree from a four-year college or university and at least three years’ experience working in public health education. Experience must include working primarily as a public health educator within the last five years. 

Training for Model Fidelity

The NC CCHC Course is offered by the NC Child Care Health and Safety Resource Center. The NC CCHC Course lasts approximately 12 weeks and includes 8 weekly Zoom meetings plus an orientation (each lasting one hour), weekly readings/videos, self-directed assignments, content-related quizzes, and one in-person session in Raleigh (lasting 2 full days). 

NOTE: Recertification is required every 3 years. CCHCs are considered inactive if they have not worked as a CCHC in the last 3 years or have not completed the course in the last 3 years.

Contact Information

Jacqueline Simmons, MScPH MCHES: Project Director, NC Child Care Health and Safety Resource Center at UNC Gillings School of Global Public Health, Department of Maternal and Child Health; 919-707-5678, jdsimmons@unc.edu

Cost Estimates

There is no cost for training CCHCs.

The average hourly pay based on field reports ranges from $22-$32/hour. Agencies will need to calculate their local fringe and overhead costs.

Purpose Service Code (PSC)

3104- NC Child Care Resource and Referral Services

3125- Quality Child Care

Program Identifier (PID)

TA Consultation and Coaching: Child Care Health Consultant

Minimal Outputs for NCPC Reporting

FY 24-25:

  • Number of child care classrooms receiving technical assistance using the NC Health and Safety Assessment and Encounter Tool (HSAET) 
  • Number of child care facilities receiving technical assistance using the NC Health and Safety Assessment and Encounter Tool (HSAET) ⌘ 
  • Number of staff receiving technical assistance 
  • Note: When conducting DCDEE Approved Training that accompanies CCHC, please also select the Training (DCDEE Approved) PID to report the number of staff participating in training funded through the CCHC activity, as well as the corresponding Outcomes and Measures.

Minimal Outcomes for NCPC Reporting

FY 24-25:

  • Increase in the provider practice of healthy behaviors

Minimal Measures for NCPC Reporting

FY 24-25:

  • NC Child Care Health and Safety Assessment and Encounter Tool

NCPC Evidence Categorization

Evidence Based

Research Summary

Technical Assistance (TA) is an array of services (off and on site, varying in duration, products, and processes) to childcare program staff for the purpose of equipping the early childhood workforce with knowledge, skills, and attitudes to provide/improve high quality experiences and environments for young children. TA is offered through services including targeted guidance, training,1 consultation,2 coaching, planning, modeling, and support.3 Assessments and trainings supported by TA include, but are not limited to, ITERS,4 ECERS,5 FCCRS,6 CLASS,7 PAS,8 BAS,9 POEMS,10 the Pyramid Model,11 and those training and supports for Licensure,12 NAEYC Professional Development standards,13 and IECMH.14 Outcomes for TA include improved access to high quality care,15 improved ECE program environment,16 improved provider and/or director knowledge,17 enhanced program quality,18 improved teacher/child interactions,19 and increase in practice of healthy behaviors,20 among others.  

The following studies are included as research relevant to supporting positive outcomes of CCHC. In Alkon et al. (2009),21 the Child Care Health Linkages Project,22 and Isbell et al. (2012),23 the CCHC sites made significant improvements on the number and quality of written health and safety policies and met more national health and safety (NHS) standards. Specifically, in Alkon et al. (2009), when consultation model, time in study, and director turnover were controlled for, treatment centers improved health and safety practices for emergency preparedness and handwashing. Similarly in the Child Care Health Linkages Project, CCHC knowledge was improved after receiving the training, as well as improvements in the percent of infants and toddlers with up-to-date immunizations for the treatment groups. There were also significant improvements in mean Health and Safety Checklist scores found in both this study and Alkon et al. (2009). In Isbell et al. the proportion of enrolled children enrolled with screening information in their files increased, including significant increases in developmental, hearing, oral, and vision screenings. Additionally, there was an increase in the percentage of children with medical homes, health insurance, and immunizations. However, there were nonsignificant changes in children with well-child physicals and emergency contact information on file. Lastly, in Alkon et al. (2002)24 there were no statistically significant differences on the health survey given pre- and post-intervention. However, the pre and posttests given for the staff workshops showed an increase in knowledge, particularly on the Communicable Disease Prevention portion. The intervention centers also improved their compliance with the National Performance Health Standards.  

  1. ^ See Le et al. (2016).   
  2. ^ See Denton & Hasbrouck (2009).
  3. ^ See Scarparolo & Hammond (2018).
  4. ^ See Buckley et al. (2020) & Rentzou (2017).
  5. ^ See Buckley et al. (2020), Neitzel et al. (2019), & Rentzou (2017). 
  6. ^ See Eckhardt & Egert (2020), Han et al. (2021), & Kelton et al. (2013). 
  7. ^ See Jamison et al. (2014), Tonge et al. (2019), & Case-Study Santa Clara (n.d.).
  8. ^ See Shore et al. (2021).
  9. ^ See De Haan et al. (2020) & Masterson et al. (2019).
  10. ^ See Cosco et al. (2014), LeMasters & Vandermaas-Peeler (2021), & Muela et al. (2019). 
  11. ^ See Fox et al. (2021), Hemmeter et al. (2021), & Hemmeter et al. (2022).
  12. ^ See Boyd-Swan & Herbst (2018), Hegde et al. (2022), Moats (2019), & Piasta et al. (2020). 
  13. ^ See National Association for the Education of Young Children, National Association of Child Care Resource and Referral Agencies (2011).
  14. ^ See Morelan et al. (2022) & Safyer (2019). 
  15. ^ See Buckley et al. (2020), Rentzou (2017), Eckhardt & Egert (2020), Han et al. (2021), Kelton et al. (2013), Jamison et al. (2014), Tonge et al. (2019), CLASS Case study by Teachstone (n.d.), Shore et al. (2021), De Haan et al. (2020), Cosco et al. (2014), LeMasters & Vandermaas-Peeler (2021), Muela et al. (2019), & Masterson et al. (2019). 
  16. ^ See Buckley et al. (2020), Rentzou (2017), Eckhardt & Egert (2020), Han et al. (2021), Kelton et al. (2013), Jamison et al. (2014), Tonge et al. (2019), CLASS Case study by Teachstone (n.d.), Shore et al. (2021), De Haan et al. (2020), Cosco et al. (2014), LeMasters & Vandermaas-Peeler (2021), Muela et al. (2019), & Masterson et al. (2019).
  17. ^ See Shore et al. (2021), De Haan et al. (2020), & Masterson et al. (2019). 
  18. ^ See Buckley et al. (2020), Rentzou (2017), Eckhardt & Egert (2020), Han et al. (2021), Kelton et al. (2013), Jamison et al. (2014), Tonge et al. (2019), CLASS Case study by Teachstone (n.d.), Shore et al. (2021), De Haan et al. (2020), Cosco et al. (2014), LeMasters & Vandermaas-Peeler (2021), Muela et al. (2019), Masterson et al. (2019), Shore et al. (2021), De Haan et al. (2020), Masterson et al. (2019), Fox et al. (2021), Hemmeter et al. (2021), Hemmeter et al. (2022), Hegde et al. (2022), Moats (2019), & Piasta et al. (2020).
  19. ^ See Buckley et al. (2020), Neitzel, et al. (2019), Rentzou (2017), Eckhardt & Egert, (2020), Han et al. (2021), Kelton et al. (2013), Jamison et al. (2014), Tonge et al. (2019), CLASS Case study by Teachstone (n.d.), Fox et al. (2021), Hemmeter et al. (2021), & Hemmeter et al. (2022).
  20. ^ See Cosco et al. (2014), LeMasters & Vandermaas-Peeler (2021), & Muela et al. (2019).
  21. ^ See Alkon et al. (2009). This randomized controlled trial included 111 childcare centers in five California counties.  Counties were selected from strata that included geography (urban, rural, mixed), population density, and poverty rate. There was random assignment to treatment and comparison groups. The measures used included the California Childcare Health Program Health and Safety Policies Checklist and the California Childcare Health Program Health and Safety Checklist. 
  22. ^ See Child Care Health Linkages Project This non-experimental comparison group study included 64 California Child Care Health Consultants, who primarily were nurses, in five California counties. This cohort of CCHC’s provided services to more than 4,561 childcare centers and 1,398 family childcare homes. Data was collected using child health record review, advocate daily encounter form, CCHP Health and Safety Checklist –Revised, the CCHP Health and Safety Policies Checklist, and the Child Care Evaluation Worksheet. 
  23. ^ See Isbell, et al. (2012). This non-experimental study included data from a final sample of 77 North Carolina child care sites (34 centers, 41 homes, and 2 faith-based programs), representing 1,871 children. Outcomes were assessed using the Advocate Daily Encounter Form, an evaluation summary, and the Child Care Evaluation Worksheet.  
  24. ^ See Alkon et al. (2002). The study was completed with a quasi-experimental design using comparison groups. Data was collected through a violence prevention intervention program. The sample included 15 urban child care centers that served children aged 3-5 from diverse backgrounds. 5 centers received health consultation services while the other 10 acted as control centers. Data was collected through a demographic questionnaire, a health survey completed pre-and post-intervention, a pre-posttest knowledge questionnaire included in the workshops, and the Health and Safety Checklist. 

Researched Population

  • Early care and education professionals

Alkon A., Sokal-Gutierrez K., Wolff, M. (2002). Child care health consultation improves health knowledge and compliance. Pediatric Nursing, 28(1), 61-65.

Alkon, A., Bernzweig, J., To, K., Wolff, M., Mackie, J.F. (2009). Child Care Health Consultation improves health and safety policies and practices.  Academic Pediatrics, 9(5), pp. 366-370. https://doi.org/10.1016/j.acap.2009.05.005 

Boyd-Swan, C., & Herbst, C. M. (2018). The demand for teacher characteristics in the market for child care: evidence from a field experiment. Journal of Public Economics, 159, 183-202. https://doi.org/10.1016/j.jpubeco.2018.02.006 

Buckley, L., Martin, S., & Curtin, M. (2020). A multidisciplinary community level approach to improving quality in early years' settings.  Journal of Early Childhood Research, 18(4), 433-447. https://doi.org/10.1177/1476718X20951239  

Case-Study Santa Clara (n.d.) Teachstone.

Child Care Health Linkages Project.  California Childcare Health Program UCSF School of Nursing September 2001–June 2004.  

Cosco, N. G., Moore, R. C., & Smith, W. R. (2014). Childcare outdoor renovation as a built environment health promotion strategy: evaluating the preventing obesity by design intervention. American Journal of Health Promotion, 28(3_suppl), 32. https://doi.org/10.4278/ajhp.130430-QUAN-208  

de Haan, E., Molyn, J., & Nilsson, V. O. (2020). New findings on the effectiveness of the coaching relationship: time to think differently about active ingredients? Consulting Psychology Journal: Practice and Research, 72(3). https://www.doi.org/10.1037/cpb0000175  

Denton, C. A., & Hasbrouck, J. (2009). A description of instructional coaching and its relationship to consultation. Journal of Educational & Psychological Consultation, 19(2), 150–150. https://www.doi.org/10.1080/10474410802463296  

Early Childhood Personnel Center. (2019). Research on Technical Assistance Models & Frameworks. https://ecpcta.org/wp-content/uploads/sites/2810/2019/11/Final-Combined-TA.pdf

Eckhardt, A. G., & Egert, F. (2020). Predictors for the quality of family child care: a meta-analysis. Children and Youth Services Review, 116. https://doi.org/10.1016/j.childyouth.2020.105205  

Ehri, L. C., & Flugman, B. (2018). Mentoring teachers in systematic phonics instruction: effectiveness of an intensive year-long program for kindergarten through 3rd grade teachers and their students. Reading and Writing: An Interdisciplinary Journal, 31(2), 425–456. https://doi.org/10.1007/s11145-017-9792-7

Fox, L., Strain, P. S., & Dunlap, G. (2021). Preventing the use of preschool suspension and expulsion: implementing the pyramid model. Preventing School Failure: Alternative Education for Children and Youth, 65(4), 312–322. https://doi.org/10.1080/1045988X.2021.1937026 

Han, M., Buell, M., Hallam, R., & Hooper, A. (2021). An intensive professional development in family child care: a promising approach. International Journal of Early Years Education, 29(2), 167-183.  https://doi.org/10.1080/09669760.2021.1914558 

Hegde, A. V., Vestal, A. R., Whited, J., Lambert, R. G., Norris, A., & Taylor, H. (2022). A Collaborative Approach Towards Mentoring and Evaluation to Support Beginning NC Pre-K Teachers Within Non-Public School Settings: Early Educator Support (EES) Program – A Model of Support and Professional Development for Teachers. In B. Zugelder & M. L'Esperance (Eds.), Handbook of Research on the Educator Continuum and Development of Teachers (pp. 381-408). IGI Global. https://doi.org/10.4018/978-1-6684-3848-0.ch019  

Hemmeter, M. L., Barton, E., Fox, L., Vatland, C., Henry, G., Pham, L., Horth, K., Taylor, A., Binder, D. P., von der Embse, M., & Veguilla, M. (2022). Program-wide implementation of the pyramid model: supporting fidelity at the program and classroom levels. Early Childhood Research Quarterly, 59, 56–73. https://doi.org/10.1016/j.ecresq.2021.10.003  

Hemmeter, M. L., Fox, L., Snyder, P., Algina, J., Hardy, J. K., Bishop, C., & Veguilla, M. (2021). Corollary child outcomes from the pyramid model professional development intervention efficacy trial. Early Childhood Research Quarterly, 54, 204–218. https://doi.org/10.1016/j.ecresq.2020.08.004  

Isbell, P., Kotch, J., Savage, E., Gunn, E., Lu, L., Weber, D. (2012).  Improvement of child care program’s policies, health practices, and children’s access to health care linked to child care health consultation. NHSA Dialog, 16(2), pp. 34-52.

Jamison, K. R., Cabell, S. Q., LoCasale-Crouch, J., Hamre, B. K., & Pianta, R. C. (2014). CLASS–Infant: An Observational Measure for Assessing Teacher–Infant Interactions in Center-Based Child Care. Early Education and Development, 25(4), 553-553. https://doi.org/10.1080/10409289.2013.822239 

Kelton, R. E., Talan, T. N., & Bloom, P. J. (2013). Alternative pathways in family child care quality rating and improvement systems. Early Childhood Research & Practice, 15(2).  

Le, L. T., Anthony, B. J., Bronheim, S. M., Holland, C. M., & Perry, D. F. (2016). A technical assistance model for guiding service and systems change. The Journal of Behavioral Health Services & Research, 43(3), 380–395. https://doi.org/10.1007/s11414-014-9439-2  

LeMasters, A. C., & Vandermaas-Peeler, M. (2021). Exploring outdoor play: a mixed-methods study of the quality of preschool play environments and teacher perceptions of risky play. Journal of Adventure Education & Outdoor Learning, 23(4), 1-13. http://doi.org/10.1080/14729679.2021.1925564  

Masterson, M., Abel, M., Talan, T., & Bella, J. (2019). Building on whole leadership: energizing and strengthening your early childhood program. Gryphon House. Retrieved August 4, 2022.  

Moats, L. (2019). Teaching spelling: an opportunity to unveil the logic of language. Perspectives on Language and Literacy, 45(3), 17–20.  

Morelen, D., Najm, J., Wolff, M., & Kelly, D. (2022). Taking care of the caregivers: The moderating role of reflective supervision in the relationship between COVID-19 stress and the mental and professional well-being of the IECMH workforce. Infant Mental Health Journal, 43(1), 55–68. https://doi.org/10.1002/imhj.21956  

Muela, A., Larrea, I., Miranda, N., & Barandiaran, A. (2019). Improving the quality of preschool outdoor environments: getting children involved. European Early Childhood Education Research Journal, 27(3), 385–396. https://doi.org/10.1080/1350293X.2019.1600808 

National Association for the Education of Young Children, National Association of Child Care Resource and Referral Agencies (2011). Early childhood education professional development: Training and technical assistance glossary. Washington, DC: National Association for the Education of Young Children. https://www.naeyc.org/glossarytraining_ta.pdf  

Neitzel, J., Early, D., Sideris, J., LaForrett, D., Abel, M. B., Soli, M., Davidson, D. L., Haboush-Deloye, A., Hestenes, L. L., Jenson, D., Johnson, C., Kalas, J., Mamrak, A., Masterson, M. L., Mims, S. U., Oya, P., Philson, B., Showalter, M., Warner-Richter, M., & Kortright Wood, J. (2019). A comparative analysis of the Early Childhood Environment Rating Scale–Revised and Early Childhood Environment Rating Scale, Third Edition.  Journal of Early Childhood Research, 17(4), 408–422. https://doi.org/10.1177/1476718X19873015 

Neuman, S. B., & Cunningham, L. (2009). The impact of professional development and coaching on early language and literacy instructional practices. American Educational Research Journal, 46(2), 532–566. https://doi.org/10.3102/0002831208328088  

Piasta, S. B., Farley, K. S., Mauck, S. A., Ramirez, P. S., Schachter, R. E., O'Connell, A. A., Justice, L. M., Spear, C. F., & Weber-Mayrer, M. (2020). At-scale, state-sponsored language and literacy professional development: impacts on early childhood classroom practices and children's outcomes. Journal of Educational Psychology, 112(2), 329–329. https://doi.org/10.1037/edu0000380  

Rentzou, K. (2017). Using rating scales to evaluate quality early childhood education and care: reliability issues. European Early Childhood Education Research Journal, 25(5), 667-681. https://www.doi.org/10.1080/1350293X.2017.1356599   

Safyer, M. (2019). 76.3 Infant/early childhood mental health (IECMH). Journal of the American Academy of Child & Adolescent Psychiatry, 58(10), 109. https://doi.org/10.1016/j.jaac.2019.07.567  

Scarparolo, G. E., & Hammond, L. S. (2018). The effect of a professional development model on early childhood educators’ direct teaching of beginning reading. Professional Development in Education, 44(4), 492–506. https://doi.org/10.1080/19415257.2017.1372303 

Schachter, R. E., Gerde, H. K., & Hatton-Bowers, H. (2019). Guidelines for selecting professional development for early childhood teachers. Early Childhood Education Journal, 47(4), 395–408. https://doi.org/10.1007/s10643-019-00942-8  

Shore, R. A., Lambert, R. G., & Shue, P. L. (2021). An evaluation of leadership professional development for early childhood directors. Leadership and Policy in Schools, 20(4), 690–703. https://doi.org/10.1080/15700763.2020.1734629  

Telford, R. M., Olive, L. S., & Telford, R. D. (2021). A peer coach intervention in childcare centres enhances early childhood physical activity: The Active Early Learning (AEL) cluster randomised controlled trial. International Journal of Behavioral Nutrition & Physical Activity, 18(1). https://doi.org/10.1186/s12966-021-01101-2  

Tonge, K. L., Jones, R. A., & Okely, A. D. (2019). Quality interactions in early childhood education and care center outdoor environments. Early Childhood Education Journal, 47(1), 31–41. https://doi.org/10.1007/s10643-018-0913-y  

Visnjic Jevtic, A. & Rogulj, E. (2022), “Should we get support or just guidelines?” (self) assessment on mentoring of early childhood education students. International Journal of Mentoring and Coaching in Education, 11(3), 262-273. https://doi.org/10.1108/IJMCE-03-2021-0048 

Weatherby-Fell, N., Duchesne, S., & Neilsen-Hewett, C. (2019). Preparing and supporting early childhood pre-service teachers in their professional journey. Australian Educational Researcher, 46(4), 621–637. https://doi.org/10.1007/s13384-019-00340-4



Local Partnerships Currently Implementing

Local Partnerships in purple have adopted TA Consultation and Coaching: Child Care Health Consultant (CCHC). Local Partnership contact information can be found here.