HEALTH ENROLLMENT HEALTH ENROLLMENT TRAININGTRAININGAUGUST 2010AUGUST 2010MATILDA ELIZONDOMATILDA ELIZONDO

Health Services Timelines Health Services Timelines and Process Diagramand Process DiagramIllustrates the Health processes that we

must conduct during the Head Start year.

◦Which includes the:

Initial sensory and developmental screenings

Establishment of medical and dental homes

Identification of additional health concerns during the child’s enrollment

Health TimelinesHealth Timelines

Medicaid’s Early Periodic Medicaid’s Early Periodic Screening Diagnostic, and Screening Diagnostic, and Treatment programTreatment programTo ensure that children receiveprompt medical and dental evaluation and/ortreatment, Head Start staff assist families toobtain a source of funding for health

services,such as Medicaid’s Early Periodic Screening,Diagnostic, and Treatment program (EPSDT).

Iffunds are not available to families, then HeadStart funds may be used [45 CFR 1304.20(c)

(5)].

EPSDTEPSDT

Early: Assessing a child's health early in life sothat potential diseases and disabilities can beprevented or detected in the early stages, whenthey can be treated most effectively;

Periodic: Assessing children's health at keypoints to assure continued healthy development;

Screening: Using tests and procedures todetermine if children screened have conditionsrequiring closer medical or dental attention,including attention to mental health problems;

Diagnostic: Determining the nature and causeof conditions identified by screenings and thoserequiring further attention; and

Treatment: Providing services needed to control,correct, or reduce physical and mentalhealth problems.

Attendance PolicyAttendance Policy1305.8 (a)(b)(c)1305.8 (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.

Consent To Release or To Consent To Release or To Request Confidential Request Confidential

InformationInformation1. All parents’ sign a Consent To

Release or To Request Confidential Information at the time they apply for the program, upon acceptance into the program, the FSW send the release forms to the health providers.

2. Added to form: This authorization is good for 12 months from the date signed or at such time that the child is no longer enrolled in the program.

THSteps Medical Check-ups Periodicity THSteps Medical Check-ups Periodicity Schedule for Infants, Children, and Schedule for Infants, Children, and Adolescents (Birth Through 20 Years of Age) Adolescents (Birth Through 20 Years of Age)

THSteps Schedule- THSteps Schedule- FootnotesFootnotes

Memorandum Of Memorandum Of UnderstandingUnderstanding

(Mou’s)(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 79401-3206 806-765-2611 extension 1029

Mou’sMou’s

Larry Combest Community Health and Wellness Center

301 E. 40th Street, Lubbock, Texas 79404- 2811 806-743-9355

South Plains Rural Health Services, Inc. 1000 Fm 300, Levelland, Texas 79336-6235 806-894-7842 extension 154

Regence Health Network 2801 W. 8th Street, Plainview, Texas 79072-6737 806-293-8561 extension 318

ResourcesResourcesTexas Health Steps providers are

on-line! An up-to date list of Region 1 THStepsproviders can be found at:

Medical providerswww.dshs.state.tx.us/region1/thstepsmedical.shtm

Dental providerswww.dshs.state.tx.us/region1/thstepsdental.shtm

Case Management providerswww.dshs.state.tx.us/region1/thstepscaseman.shtm

Parent Consent for Parent Consent for ServicesServices

Print all information using Blue ink pen!Do not leave any blanks.Section 1.- Put child’s full nameSection 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.

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 for Release or to Consent for Release or to Request Confidential Request Confidential

InformationInformation 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. Added to form was the following Statement: This

authorization is good for 12 months from the date signed or at such time that the child is no longer enrolled in the program.

Medical and Dental Medical and Dental Emergency Consent/History Emergency Consent/History

FormForm 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 5.-7. 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 LetterPhysical LetterPrint 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 ExamPhysical 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.

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 FormDental 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 4. -5. 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 ChildrenDiet 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 Tuberculosis (TB) Screening Education ToolEducation 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.

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 Risk Assessment for Lead Exposure: Parent Exposure: Parent

QuestionnaireQuestionnairePrint 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 FormImmTrac FormPrint 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??????Questions??????Answers…..