Head Start embraces a comprehensive vision of health and wellness for children, families, and staff. The following resource may assist Head Start personnel in educating medical providers and parents about Head Start health services.
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Early Childhood Development and Health
See PDF version: Head Start; Partner Smart» [PDF, 107KB]
Head Start’s commitment to wellness embraces a comprehensive vision of health for children, families, and staff. One objective of Child Health and Development Services is to ensure collaboration among families, staff, and health professionals. When child health and developmental concerns are identified children and families are linked to an ongoing source of continuous, accessible care (Medical Home) to meet their basic health needs. The focus of Head Start health services is prevention and early intervention. Strong partnerships are the key to the success of this approach.
Once a medical home is identified, programs periodically review health records to ensure that recommended treatment and preventive services are being provided. They also assist the parents in understanding and completing both treatment and follow-up recommendation from their Medical Home.
Additional services Head Start programs provide to parents include:
- Assistance in finding a medical home;
- Locating sources of funding for health services;
- Working with local Medicaid and CHIP agencies to determine a child’s eligibility for medical assistance; and
- Tracking health services; and Offering health promotion activities, including information about well child care and family wellness, and training on child growth and development.
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A child’s health must be screened for developmental, behavioral, and sensory problems (including hearing, vision, and speech) within 45 days after entry into the program. A health care professional must determine the child’s health status within 90 days of entry. Once the program has documentation of the child’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) exam the program tracks and identifies the next due date (12 months). Staff members should work with families and provide reminders of the required EPSDT components prior to the due date. Head Start parents are encouraged to become well-informed advocates for their child.
States are required to cover the following services under the EPSDT component. Screening services, the core of the EPSDT benefit package MUST include:
- A comprehensive health and developmental history, including a physical and mental health assessment;
- A comprehensive unclothed physical examination;
- Appropriate immunizations according to the schedule of the National Advisory Committee on Immunization Practices (ACIP);
- Laboratory tests MUST include anemia and blood lead level;
- Health education, including anticipatory guidance;
- Hearing services, including hearing aids;
- Vision services, including eyeglasses;
- Dental services, including restoration of teeth and maintenance of oral health; and
- Other necessary health care diagnostic services and treatment.
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All Medicaid-eligible children are considered at risk and must be screened for lead poisoning. The Centers for Medicare and Medicaid Services (CMS) require that all children receive screening blood lead tests at 12 months and 24 months of age. Children between the ages of 36 months and 72 months of age must receive a screening blood lead test if they have not been previously screened for lead poisoning. A blood lead test must be used when screening Medicaid-eligible children. A blood lead test result equal to or greater than 10 ug/dl obtained by capillary specimen (fingerstick) must be confirmed using a venous blood sample.
At this time, states may not adopt a statewide plan for screening children for lead poisoning that does not require lead screening for all Medicaid-eligible children.
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Ongoing Collaborative Relationships
Agencies are encouraged to form partnerships with local health providers, such as pediatricians, nurses, nurse practitioners, dentists, nutritionists, and mental health providers, who represent private departments; the Women, Infants, and Children (WIC) program; dental schools, professional associations and other social services agencies. The Health Services Advisory Committee (HSAC) can offer information about providers and resources in the community. Head Start staff and parents also serve on the HSAC. The role of the HSAC is to advise in the planning, operation, and evaluation of health services in Head Start and Early Head Start programs [CFR 45 1304.41(B)]. If you are not already a member of your local grantee’s HSAC, please call the Health Manager and volunteer to participate or delegate participation to a staff member. Your input is both important and welcome.
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Head Start Health Services Performance Standards require:
- Determining child health status
- Screening for developmental, sensory and behavioral concerns
- Extended follow-up and treatment
- On-going care, including a daily health check
- Involving parents
- Individualization of the program
- Health emergency procedures
- Conditions of short-term exclusion and admittance
- Medication Administration
- Injury prevention
- Hygiene practices
- First-aid
- Identification of nutritional needs
- Nutrition services
- Meal service
- Family assistance with nutrition
- Food safety and sanitation
- Mental health services
- Parent education in health, dental, nutrition, mental wellness and safety
- Ongoing staff training
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Head Start programs are required to administer medications to children who have been prescribed medication by a medical professional. Ideally physicians would prescribe the dosage so it can be given at home, rather than in the Head Start classroom. When a medication can be taken early in the morning, after school and at bedtime, it allows the parent to retain the responsibility for their child’s treatment. It also allows the parent to identify any side effects that may occur; after all, the parent would recognize something out of the ordinary quicker than a Head Start staff member would.
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Oral Health is an important part of the Head Start program. Head Start children brush their teeth at least once a day during their time at the center. Many programs require that they brush after both breakfast and lunch.
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- There is no required format for documenting EPSDT exams. The physician and local program can use what works best for both parties.
- Programs need to know the physician's objective assessment of each child’s hearing and vision, as well as the outcome of the developmental/behavioral assessment and anemia screening, all of which are required in the EPSDT exam. If there is a concern, please note your recommendation for further examination, referral or treatment.
- All Head Start and Early Head Start children must have documentation of the required blood lead level screening.
Medicaid, Head Start, and the Office of Child Care share similar program goals: to ensure that low-income children have a medical home and to increase the Medicaid enrollment and participation rates for eligible children and families. Thank you for your work and support of Head Start children and families.
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Head Start; Partner Smart. HHS/ACF/OHS. 2010. English.
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