Structural Elements of Child Care

I want to add a couple of thoughts to my previous post re: child care professional development. I want to make a distinction between programs and grass-roots structures, and use an analogy from health care. A current big idea in health care is to develop local and/or regional “medical homes”, to replace the ancient pattern of various doctors operating as separate entrepreneurs out of individual shops (a cottage industry model). The most striking model is Burlington’s Community Health Center, an integrated delivery system – one-stop shopping, but much more than that because of the fact of integrated services. The relationship between BCHC and the surrounding community is one in which the center accepts a comprehensive responsibility for all aspects of health care needs, i.e. it has a public health perspective as well as a medical practice perspective.

The center is an organizing and distribution system for bringing health care knowledge and professionals into a committed relationship with the entire local population. The center is the structural element in the plan for a community’s care, as the local church is for the exercise of religion, a school is for education, or a supermarket for food etc.

As noted in my previous post, Chittenden County’s Child Care Resource center has the characteristics of a structural element in a childcare system; so does a parent-child center. They are designed to have an enduring existence, a constant presence. They have local knowledge, local governance. They are “distribution centers” in the sense that, for example, the providers of a particular program/product aimed at literacy education can market their stuff there, on the basis of an on-going working relationship with the center. They are also centers for knitting together the often isolated local providers of direct services; and centers for promoting professional development, and providing scarce resources such as professional consultation in education, mental health etc.

The two structures I mentioned are only partial models of a child care and education center, but they could be developed further (needing careful tailoring to what would fit particular and diverse Vermont communities). VCPC‘s work on pre-K and its current ‘leadership’ project point in the right direction.

I would like to see Henderson, the Permanent Fund and VCPC explore possibilities for building stronger local structural elements into Vermont’s child care system. I also hope that Building Bright Futures can be viable as a structural feature whose purpose is to build a coherent plan for public support – but I’m not keen on regional “coordinating councils”. I’ve seen them eat up a lot of people’s time and energy to not much purpose.

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Arnold Golodetz, MD