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FY 2003 Annual Performance Plan

6. IMPROVE THE HEALTH STATUS OF CHILDREN

Approach for the Strategic Objective: For children enrolled in Head Start, provide access to regular medical and dental examinations, immunizations and required medical and dental treatments.

6.1 HEAD START: HEALTH STATUS

Program Description, Context, Legislative Intent and Broad Program Goals

Head Start emphasizes the importance of the early identification of health problems. Every child is in a comprehensive health program that includes immunizations, medical, dental, and mental health, and nutritional services.

The Head Start program has made a considerable investment in measuring program outcomes, particularly in the health areas. When this information is analyzed over time, it demonstrates that grantees are maintaining a high level of effort, especially in accomplishing a nearly 100 percent rate for child immunizations and rates approaching 90 percent for health examinations. Head Start sees the need for improvement in the rates of treatment for mental health referrals and receipt of mental health services for children. Basic to the philosophy of the Head Start program is that healthy children will be better able to learn.

Head Start has measured health component outcomes for more than twenty years. Trend data over the past several years show that most Head Start grantees have maintained an acceptable level of performance in the area of health services. While not direct providers of health services, Head Start grantees assist families to access care by identifying health care providers and even providing families with transportation to and from health services. The newly revised Head Start Performance Standards require that every program help every child and family to identify a "medical home" which will provide the child with ongoing sources of medical care.

Every year Head Start polls 1,525 Head Start grantees using the annual Head Start Program Information Report (PIR) survey to measure several health indicators, including immunization rates, screenings for health and dental health conditions, and the rates for accomplishing treatment for identified conditions. During the past several years Head Start has also measured the rate of referral and treatment for mental health conditions. The Summary Table below shows the results reported by all 1,525 reporting grantees since 1998. Generally, Head Start programs are maintaining acceptable results as shown on the table below for indicators measured.

Program-wide Performance

The summary table below compares the actual performance, as reported by 1,525 Head Start and Early Head Start grantees on the Head Start Program Information Report (PIR) for the reporting period ending in June 2001. Head Start devotes considerable time and energy to survey mailing, data collection, and data cleaning, database building and database management. These reports (more than 2400 reports were submitted) tracked performance for over 850,000 children in the FY 2001 reporting period.

Programs reported that 88 percent of enrolled children receive treatment for identified medical conditions. It is important to note that Head Start has a predictable turnover rate; that is, children leave the program during its course for various reasons. So while a referral may have been made, programs may not have follow-up information for children who have left the program.

While performance has remained stable for measures 6.1a and c with a slight decrease in 6.1b; all three Head Start health indicators (measures 6.1a-c) are below the projected target levels. However, the number of children identified as needing treatment has increased for all three measures and the number actually receiving treatment has increased in measures 6.1a and 6.1c. Since Head Start program enrollees rely heavily on Medicaid services, the Head Start Bureau suspects that levels of reimbursements to providers, particularly dental health providers, are not sufficient to encourage the provision of services to Medicaid recipients. The result is that Head Start children experience delays in receiving such services. Dental treatment targets may be difficult to reach in the coming years as dental providers accepting Medicaid are scarce in some communities. This may also be a factor in mental health treatment for young children. The Head Start Bureau is committed to improving performance for these three measures for FY 2003 because health plays such a critical role in the overall positive development of children.

Summary Table

Performance Measures	Targets	Actual Performance	Reference (page # in printed document)
PROGRAM GOAL: Children in Head Start receive health and nutritional services.
Objective: Children in Head Start receive needed medical, dental and mental health services.
6.1a. Increase the percentage of Head Start children who receive necessary medical treatment after being identified as needing medical treatment.	FY 03: 97% FY 02: 94% FY 01: 92% FY 00: 90% FY 99: 88%	FY 03: FY 02: FY 01: 88%* FY 00: 88% FY 99: 87% FY 98: 88%	Px 127
*204,297 children were diagnosed as needing medical treatment and 178,840 received or are receiving treatment.
6.1b. Maintain the percentage of Head Start children who receive necessary dental treatment after being identified as needing dental treatment.	FY 03: 95% FY 02: 90% FY 01: 90% FY 00: 90% FY 99: 96%	FY 03: FY 02: FY 01: 77% FY 00: 78% FY 99: 81% FY 98: 83%	Px 127
**221,456 children were diagnosed as needing dental treatment and 170,405 received or are receiving treatment.
6.1c. Increase the percentage of Head Start children who receive necessary treatment for emotional or behavioral problems after being identified as needing such treatment.	FY 03: 90% FY 02: 85% FY 01: 83% FY 00: 81% FY 99: 81%	FY 03: FY 02: FY 01: 77%*** FY 00: 77% FY 99: 75% FY 98: 75%	Px 127
***48,415 children were referred for mental health treatment. 37,432 received treatment.

 

Performance Measures for FY 2003 and Final Measures for FY 2002

PROGRAM GOAL: Children in Head Start receive health and nutritional services.

Objective: Children in Head Start receive needed medical, dental and mental health services.

 

 

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