Caring for Our Children (CFOC)

Chapter 8: Children with Special Health Care Needs and Disabilities

8.4 Developing a Service Plan for a Child with a Disability or a Child with Special Health Care Needs

8.4.0 Designation and Role of Staff Person Responsible for Coordinating Care in the Child Care Facility

If a child has an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP), or any plan for medical services, the child care facility should designate one person in the child care setting to be responsible for coordinating care within the facility and with any caregiver/teacher or coordinator in other service settings, in accordance with the written plan. The role of the designated person should include:

  1. Documentation of coordination;
  2. Written or electronic communication with other care or service providers for the child, including their medical home, to ensure a coordinated, coherent service plan;
  3. Sharing information about the plan, staff conferences, written reports, consultations, and other services provided to the child and family (informed, written parental/guardian consent must be sought before sharing this confidential information);
  4. Ensuring implementation of the components of the plan that is relevant to the facility.

When the evaluators who are to determine if the child has special health care needs or is eligible for services under the Individuals with Disabilities Education Improvement Act (IDEA 2004) are not part of the child care staff, the lead agency should develop a formal mechanism for coordinating reevaluations and program revisions. The designated staff member from the facility should routinely be included in the evaluation process and team conferences. Any care plan should be updated whenever the child is hospitalized or has a significant change in therapy.

One person being responsible for coordinating all elements of services avoids confusion and allows easier and more consistent communication with the family. When carrying out coordination duties, this person is called a child care coordinator or service coordinator. Each child should have a care coordinator/service coordinator assigned in the child care facility at the time the service plan is developed.

With more than half of all mothers in the workforce, caregivers other than the parents/guardians (such as teachers, grandparents, foster parents, or neighbors) frequently spend considerable time with the children. These caregivers/teachers need to know and understand the aims and goals of the service plan; otherwise, program approaches will not carry over into the home environment.

This requirement does not preclude outside agencies or caregivers/teachers from having their own care coordinator, service coordinator, or case manager. The intent is to ensure communication and coordination among all the child’s sources of care, both in the facility and elsewhere in the community. The child’s care coordinator or service coordinator does not have responsibility for directly implementing all program components but, rather, is accountable for checking to make sure the plans in the facility are being carried out, encouraging implementation of the service plan, and helping obtain or gain access to services.

A facility assuming responsibility for serving children with disabilities or children with special health care needs must develop mechanisms for identifying the needs of the children and families and obtaining appropriate services, whether or not those children have an IEP/IFSP. The child care coordinator will be responsible for coordination of health services with the program child care health consultant, as needed.

Usually, the person who coordinates care or services within the child care facility will not be the person assigned to coordinate overall care or provide overall case management for the child and family. Nevertheless, the facility may assume both roles if the parents/guardians so request and state law permits. The components and the role may vary, and each facility will determine these components and roles, which may depend on the roles and responsibilities of the staff in the facility and the responsibilities assumed by the family and care providers in the community. The person who coordinates care or services within the child care facility may be the Health Advocate or someone else who is working closely with the child’s family and the teaching staff in the facility.
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Qualifications and Responsibilities for Health Advocates Child Care Health Consultants Resources for Parents/Guardians of Children with Special Health Care Needs Compensation for Participation in Multidisciplinary Assessments for Children with Special Health Care or Education Needs