Recognizing the economic impact of the child care industry and based on the needs of at-risk young children, Louisiana policymakers and stakeholders reorganized the child care industry after Hurricanes Katrina and Rita and developed a quality rating system using early childhood mental health consultation (ECMHC) as a primary support. Child care programs have embraced the ECMHC model, reporting positive subjective changes, and objective changes on the Classroom Assessment Scoring System have been observed. The ECMHC model developers are working to adapt to the ongoing changes in early education in Louisiana so that all young children are ready for school. (author abstract)