HEALTH ENROLLMENT TRAINING MAY 9, 2011 MATILDA ELIZONDO

Health Services Timelines and Process Diagram Illustrates the Health processes that we must conduct during the Head Start year. ◦ Which includes the: Initial sensory and developmental (vision, strabismus, hearing) screenings Establishment of medical and dental homes Identification of additional health concerns during the child’s enrollment

Health Timelines

Medicaid’s Early Periodic Screening Diagnostic, and Treatment program To ensure that children receive prompt medical and dental evaluation and/or treatment, Head Start staff assist families to obtain a source of funding for health services, such as Medicaid’s Early Periodic Screening, Diagnostic, and Treatment program (EPSDT). If funds are not available to families, then Head Start funds may be used [45 CFR (c)(5)].

EPSDT Early: Assessing a child's health early in life so that potential diseases and disabilities can be prevented or detected in the early stages, when they can be treated most effectively; Periodic: Assessing children's health at key points to assure continued healthy development; Screening: Using tests and procedures to determine if children screened have conditions requiring closer medical or dental attention, including attention to mental health problems; Diagnostic: Determining the nature and cause of conditions identified by screenings and those requiring further attention; and Treatment: Providing services needed to control, correct, or reduce physical and mental health problems.

THSteps Medical Check-ups Periodicity Schedule for Infants, and Children, (Birth Through 10 Years of Age)

Attendance Policy (a)(b)(c) Processes, Documents and Tracking: ◦ 1. A complete and up to date health exam is required for all children prior to attendance at a licensed grantee site. ◦ 2. A complete and up to date health exam is required for all children to be completed at scheduled onsite clinics or prior to attendance at partner sites.

Memorandum Of Understanding (Mou’s) Federally funded clinics to be used for physicals and dentals of Head Start children. Four(4) clinics will have Mou’s with Head Start. ◦ Community Health Center of Lubbock  1318 Broadway, Lubbock, Texas  extension 1029

Mou’s Mou’s Larry Combest Community Health and Wellness Center  301 E. 40 th Street, Lubbock, Texas  South Plains Rural Health Services, Inc.  1000 Fm 300, Levelland, Texas  extension 154 Regence Health Network  2801 W. 8 th Street, Plainview, Texas  extension 318

Resources Texas Health Steps providers are on-line! An up-to date list of Region 1 THSteps providers can be found at: Medical providers Dental providers Case Management providers

Parent Consent for Services Print all information using Blue ink pen! Do not leave any blanks. Section 1.- Put child’s full name Section 2.- We prefer all answers to be YES, however if parent answers NO, FSW’s will need to re-ask to clarify answer if still NO document and let CD/TL know. #11 is a new question- permission for children’s picture to be taken. Section 3.-Must be signed and dated by the staff person completing the form. Ensure the Parent or Guardian have also signed. Form will be entered into Child Plus by FSW’s, and filed in the child’s brown folder under flap #5.

Consent To Release or To Request Confidential Information 1. All parents’ sign a Consent To Release or To Request Confidential Information at the time they enroll into the program. 2. This consent will be used if we need to get the needed information from the provider. Deleted from the form was the following Statement: or at such time that the child is no longer enrolled in the program.

Consent for Release or to Request Confidential Information Print all information using Blue ink pen! Do not leave any blanks. Section 1.-Check proper box, child’s name and date of birth. Section 2.- Left side of form is for Head Start staff to fill out Section 3.- Right side of form is for Agency to whom request made. Section 4.-Check proper box for information being requested. Section 5.-Staff name and telephone number. Section 6.-Check proper box for yes or no answer. Section 7.- Signature of Parent, Guardian, or Surrogate parent and dated. Section 8.- Must be signed and dated by interpreter if used. Deleted from the form was the following Statement: or at such time that the child is no longer enrolled in the program.

Consent for Lead and/or Hematrocrit Testing using a Finger Stick Method All parents’ sign a Consent for Lead and/or Hematocrit Testing using a Finger Stick Method at the time they enroll into the program. This consent will be used if we can not get the needed results from the provider.

Consent for Lead and/or Hematocrit Testing using a Finger Stick Method Instructions All information must be printed and a Blue pen is to be used. Section #1, To be completed at time of enrollment as part of the enrollment process. This form is good for one (1) year from date signed. ◦ Do not leave any blanks. ◦ Please fill in Medicaid or insurance information. Section #2, To be completed at time of enrollment as part of the enrollment process. ◦ All blanks need to be completed. ◦ Please have parent complete address with City and Zip. ◦ Ethnicity and Race must be checked as this is used in reporting to the state of Texas. ◦ Please include the child’s primary physician and location. Section #3, To be completed by SPCAA Nurse at the time the blood work is completed. The Consent for Lead and/or Hematocrit will be filed in the child’s brown folder under flap #4 to be used if needed.

Medical and Dental Emergency Consent/History Form Print all information using Blue ink pen! Do not leave any blanks. Section 1. complete parent’s name, child’s name and site name. Section 2. – 4. print name, address with city, state, and zip and phone number. Section print name, address with city, state and zip and phone number. Section 8.- all answers are to be circled NO unless you have a diagnosis from the medical provider at the time this form is completed. Section 9. – must be signed by parent and staff and dated. Form will be entered into Child Plus by FSW’s, and filed in the child’s brown folder under flap #5.

Physical Letter Print all information using Blue ink pen! Do not leave any blanks. Section 1. – complete Center/Partner Name, date, and child’s name. Section 2. - review section #2 with the parent or guardian at time of enrollment. Section 3. - all of these items must be completed on the physical exam form to be considered complete. Section 4. - contact information for the parent.

Physical Exam Print all information using Blue ink pen! Do not leave any blanks. Section 1.- Complete child’s name, sex, and birthdate. Site name, address, and phone number including city, state, and zip. Also circle payment source. Section 2. – transfer any YES answers from the Medical and Dental Emergency Consent/History from to this section for provider to address. Section 3. – Screening test results completed by provider. Section 4. - physical exam section to be completed by provider. Section 5. – any additional comments provided by physician at time of physical exam. Section 6. – original medical provider’s signature and date. Section 7. – any findings, treatment, or recommendations that will need follow-up. Form will be entered into Child Plus by Monitor’s, and filed in the child’s brown folder under flap #4.

Dental Health Form Print all information using Blue ink pen! Do not leave any blanks. Section 1.- Complete child’s name, sex, and birthdate. Site name, address, and phone number including city, state, and zip. Section 2. - #1-8 must be completed by the staff person completing the enrollment. Section 3. - #10 is to be completed by the dentist including the date the exam was performed. Section are to be completed if preventive care was needed or completed. Section 6.-to be completed by dentist for dental treatment. Section ‘A’ marked when treatment is needed and ‘B’ marked when NO treatment needed. Section 7. – to be completed by dentist and checked YES or NO. Section 8. – Dentist must check services are completed with original signature and date of Dentist performing services. Form will be entered into Child Plus by Monitor’s, and filed in the child’s brown folder under flap #4.

Diet History for Children Print all information using Blue ink pen! Do not leave any blanks. Section 1. – complete with Center/Partner Name, child’s name, and date Section 2. - #1.(a-f) are to be filled out with parent circling how many times a day foods are eaten from food groups. Section 3.- #2. (a-i) are to be filled out with parent checking Yes or No. Section 2 letter (e) indicates possible problems with PICA. When the response is YES to this question the Diet History for Children is entered into Child Plus as a failed event and a follow-up is needed to be completed by dietitian with the parent or guardian. Section 4. – letters (j-o), ask parent and circle appropriate response. All YES answers must be explained in space provided. Section 5. – must be signed and dated by parent and staff completing the form. Section 6.- staff completing Diet History for Children with parent will need to check the following spaces at bottom of page: ( ) Reviewed response with parent ( ) Gave Child Pyramid handout Form will be entered into Child Plus by FSW’s, and filed in the child’s brown folder under flap #6.

Tuberculosis (TB) Screening Education Tool Print all information using Blue ink pen! Do not leave any blanks. Section 1. – complete with Center/Partner name, child’s name, and date. Section 2. – an ‘X’ will be placed under the section parent indicates.  If any answers are “yes” or “I don’t know” the child Must have a TB skin test completed and provide results.  When a “YES” or “I Don’t Know” is noted on the form TB questionnaire will be entered into Child Plus as a failed event  If child fails TB questionnaire after a TB test has been completed, the child will need an additional TB test. Form will be entered into Child Plus by FSW’s, and filed in the child’s brown folder under flap #4.

Risk Assessment for Lead Exposure: Parent Questionnaire Print all information using Blue ink pen! Do not leave any blanks. Section 1. – complete with Center/Partner name, child’s name, and date. Section 2. – an ‘X’ will be placed under the section parent indicates.  If “I Don’t Know: or “YES” is marked then the child will need a lead test completed.  When a “YES” or “I Don’t Know” is noted on the form the Risk Assessment for Lead Exposure will be entered into Child Plus as a failed event  If child fails Lead questionnaire after a Lead test has been completed, the child will need an additional Lead test. Form will be entered into Child Plus by FSW’s, and filed in the child’s brown folder under flap #4.

ImmTrac Form Print all information using Blue ink pen! Section 1. - Do not leave any blanks  Be sure to include child’s middle name. Section 2. - Parent or guardian must print name, sign and date form. The ImmTrac form is not to be put in the child’s brown folder. The ImmTrac form is sent to the Health Assistant by Inter office mail to the Levelland office.

Questions?????? Answers…..