IV.ENROLLMENT PROCEDURES
Performance Standard 1304.20(e) (3)
Performance Standard 1305.7
Performance Standard 1308.5
Minimum Standard 746.605
POLICY
Enrollment of children into Head Start gives the Health Staff opportunity to identify any potential health problems that may interfere with a child’s learning ability, self-esteem etc. If a problem is identified, the Head Start Health Staff should work with the family and staff to ensure that the child receives the care or treatment needed until the plan is implemented, monitored and/or resolved.
It is the responsibility of the Head Start Health staff to inform parent(s) of all required health services, as well as the rationale and expectations for those services. All children enrolled in the Head Start program are required to receive a physical examination and health screenings. Health screenings include impedance, pure-tone hearing, BP, vision, strabismus, growth assessment, anemia screening, results of a lead test as well as a dental examination. Children in the Head Start Program must show proof of at least one lead test. EHS children will be required to show resultsof a lead test at ages12and 24 months.
Enrollment schedules are coordinated through the Family Advocate Specialist. Scheduling of enrollments and re-enrollments should be coordinated inteam meetings held at each center (Site-Managers responsibility). All staff members should be notified of a scheduled enrollment atleast a minimum of threedays prior. This arrangement will ensure the availability of staff for each enrollment.
To ensure compliance, all children scheduled for enrollments (both new and returning) must be up to date (current) with their health information. Health Staff should work with families to ensure health requirements are updated according to Texas Health Steps’ Periodicity Chart throughout the year. For correct input on the data entry system for enrollments, see Chapter 12.
SPECIAL NOTE:
All enrollment and re-enrollment will be documented on the data base system. All forms on the data base system are in English. Parents/guardians are required to signforms on the data base system. For those families who do not speak English, staff should have the translated forms available for them to read. Parents will be instructed to sign on the data system after reading the forms. If there are questions, a translator should be available or obtained.
A)PRE-ENROLLMENT PROCEDURE & PACKET (HC-27)
PROCEDURE
1)A Family Advocate Specialist will send letters to the parents of children eligible for the Head Start Program informing them of their enrollment date at the Center.
a)The “Pre-enrollment” letter sent to the parents and/or guardians of children will give in detail,the Head Start requirements including health information. A green-colored physical (HC-6), dental (HC-8), and a white-color lead (HC-118) form should be attached to the application.
b)The green-colored physical form (HC-6), dental (HC-8) and lead results (HC-118) is required to be completed by the child’s health care provider. This form should be returned to the Health staff at enrollment or prior to their date of entryinto the center.
c)Children with Medicaid, CHIP, or private insurance should bring an updated physical exam to the centerHealth Staff prior to entry.
d)Children with Medicaid or dental insurance should bring an updated dental exam to the center to be givento the Health Staff prior to entry.
e)Current health information should be input, scanned on the data system, and documented on the Health (excel) control tracking form.
EXCEPTIONS
School Districts
Those centers associated with school districts will be allowed an additional two weeks after the schools’ start date to turn in their health information because parents may not have received any prior notice.
1)Parents in this exception will adhere to the same procedure described above (medical home vs. non-medical home).
2)Completed forms should be documented on the health tracking forms.
Adoptions/ Foster Homes
Occasionally, children are suddenly adopted or put in foster homes without
havingtheir current health information available. Based on these situations,
(court mandates, etc.) these families (children) will be given 30 days
to comply withhealth requirements for Head Start.
Improving Head Start for School readiness Act of 2007
This act was signed into law, reauthorizing Head Start programs to provide services for children who are homeless, as defined under the McKinney-Vento Homeless Education Assistance Act.
Head Start of Greater Dallassigned a partnership agreement with Vogel Alcove in 2005/6. The purpose was “to provide an effective vehicle through which interested members of the Dallas Jewish community can work together in helping to alleviate the plight of the homeless in Dallas.” Staff will adhere to the following for families enrolled:
- An additional 30 days will be given to parents to obtain information relating to immunizations. If no information is obtained, then children will be expected to start a series of immunizations. Immunizations will be kept up to date according to the Texas Health and Human Services.
- All other health information should be obtained during enrollment. Health requirements will be implemented the same as uninsured families.
B)CENTER ENROLLMENT PACKET
During enrollment, the health center staff will interview parents in their office or at adesignated station. Staff will introduce themselves and fill out all health forms on the data base system. Children with health insurance are required to bring their health information prior to the child entering into the agency. Health staff should come prepared to make a list to identify children with incomplete or delinquent informationandhealth concerns.
PROCEDURE
The following forms are on the data base and should be filled out correctly by the Health staff during enrollments. Staff should obtain parental signatures for all health formsrequired for enrollment. The following procedure is to be implemented for both EHS and HS centers.
1)SERVICES PERMISSION FORM (HS-1)
(Standard, 1304.53(a) (6)
POLICY
All parent(s) and/or guardians (Head Start and Early Head Start) will be informed of the comprehensive services and health requirementsfor children enrolled in the Head Start and Early Head Program. Parents sign this form indicating they have received the appropriate information and give permission for services to be provided to their child while enrolled in the agency. No service can be provided to the children until this form is signed by the parent/guardian.
Head Start and Early Head Start programs will update this form annually during re-enrollments.
PROCEDURE
1)The parent(s) and/or guardian must provide the child’s name, date of birth, and sex, by proof of the Birth Certificate.
2)Names are to be spelled the same as written on the birth certificates even if the names are misspelled. The Head Start staff member should encourage the parent(s) and/or guardian to apply for another birth certificate with the correct spelling of the child’s name.
3)Should the parent(s) and/or guardian fail to bring the child’s birth certificate at the time of enrollment, the child’s name, sex and birth date is entered on the data system or forms. Corrections with spelling will be made after receiving/reviewing an updated birth certificate.
4)Parents should provide home and work number(s), parent’s name, and address. If the child has health insurance, a copy will be made of the form and the company and number should be recorded. Staff should record the center’s name on the form.
5)Staff will discuss all required health services with parents during enrollment. Staff will mark all servicesthat could be provided by Head Start staff. Services unmarked on the data base system will not be provided by Head Start health staff.
6)The parent(s) and/or guardian must also sign in the space for the “Signature of Parent or Legal Guardian”.
7)One copy of the Services Permission Form should be printed from the data base system and
- a copy given to the parent at enrollment and re-enrollment
- if using a manual for pink copy - given to parent at original
enrollment and given a yellow copy at re-enrollment.
8)The parent(s) and/or guardian may refuse the Health Staff to provide/perform services for their child. When this occurs the area should be left unmarked. However,all mandated servicesvia Head Start Performance Standardsare required. Parents will be required to provide this information to the Health Staff prior to their child’s start date.
Mandated services are physical examination, dental exam,updated immunization/affidavit,
Parents may refuse to allow staff to perform screenings, but the screenings must be submitted within 30days after entering the center. Required screenings are: ht. wt., hemoglobin, lead screening result (one), vision, impedance, blood pressure and pure-tone.
9)Parent(s) and/or guardian will often be asked to get treatment for health concerns identified based on behavior, screening or history. Staff should always stress the importance of getting these services for their child by providing educational materials, as well as one-on-one discussions with parents. If refusal is exhibited after three attempts and longer than 30 days after the due date, staff should refer this family to the Site Manager and Family Advocates.
10)Health staff will ask parents to sign the Refusal of Service/Treatment Form (HC-1)identifying which service/treatment that the parent is refusing. The parent will sign and date this form.
(Standard, 1304.20(e) (5))
“I will be responsible for the following: (HC-1)
Only create this formwhen staff has documented the efforts that have been made to educate the parent and/orget the requested information from the parent. The center’s team may need to address concerns relating to the importance of the health information. The “Refusal of Service/Treatment Form (HC-1)” is on the data base system and a signature must be obtained.
11)Explain to the parent(s) and/or guardian, they will be responsible for keeping the immunizations current, using Medicaid/CHIP/Private insurance and referrals to free or community clinics. Parents/guardians will be expected to bring a copy of updated information to the Health staff.
12)Staff will notify the parent of Missing Health information (HC-29)prior to their entry into the center. NO CHILD SHALL BE ENROLLED OR RE-ENROLLED WITH DELINQUENT INFORMATION.
13)Parent(s) and/or guardian should sign form HC-13 (Consent for Child to Receive Medical/Dental Treatment) when the Health staff is responsible for transporting children for medical or dental services/treatment.
14)After all forms are explained,filled outand signed by parents, staff will summarize all the health services that are required to ensure the parent has an understanding of the Health Content Area requirements.
15)After explaining health servicesrequirements, the parent(s) and/or guardian must sign the “Service Permission Form” on the data system (English/Spanish/Vietnamese are available in a manual form).
16)This form can/should be created again in any program year when obtaining parental consent for Speech /Language, Emotional/Behavioral Wellness, Developmental, and Educational services. Special Services staff must inform parents of the services that will be provided and obtain aparental signature.
RE-ENROLLMENT
17)During Re-enrollment, Health staff will inform the parent(s) and/or guardian of all health services available and requirements. The Service Permission form will roll over for the next year. This form must be updated and a new signature must be obtained by parentsin order to providehealth services for the upcoming year.
18)During re-enrollment, staff will discuss all required health services with parents during enrollment. Staff will mark all services that could be provided by Head Start staff. Services unmarked on the data base system will not be provided by Head Start Health staff.
19)Parent should be informed during re-enrollment that children with health insurance will be expected to bring an updated physical to the Health staff at the start of the next year. Dental screenings will be requested from those children with Medicaid CHIPs or dental insurance.
2)MEDICAL HOME FORM (HC-2)
(Standard, +1304.20(a) (l) (i))
POLICY
During enrollment, the Medical Home Form is used to identify the medical home/providerand health insurance status of the child in Head Start and Early Head Start. This process is completed within the first ninety (90) days of entry into the center by the health staff.
For those children identified without a medical home or insurance during enrollment (and re-enrollment), staff should assist parent inlocating a medical home and obtain health insurance for all eligible families. For a list of Medicaid providers, staff can assist families by going to On the LEFT side of the website there is a box that says “Looking for a provider”.Click on it and go through the prompts. Parents must put in the correct zip code.It is also available in Spanish at this same website.
At enrollment staff should print up a copy of the TexCare application for Medicaid/CHIP (off the share drive). The address to mail forms is HHSC, P.O. Box 14200, Midland, TX. 79711-9901. Applications can be downloaded at:
Health staff should assist families in filling out his application when indicated.
- Medicaid Client Hotline: (800) 252-8263
- Apply for CHIP/Children's Medicaid: (800) 647-6558
The PIR report requires Head Start and Early Head Start programs to identify the insurance status of the child at enrollment and at the end of the year. Because health insurance status may change, Staff will reviewthe insurance status of all children during the month of Februaryand complete them prior to re-enrollments. This will reflect the end of the year medical home status. For those children entering the agency after February, all information should be updated prior to re-enrollment or by the end of May.
PROCEDURE
Heath staff will determine at enrollment from the parent interview whether or not the child has a “medical home.” If it is determined that the child
1)has either Medicaid/CHIP or private insurance; the parent should identify their primary care provider (PCP) from their health directory. Those children with Medicaid/CHIP and private insurance will be required to provide physical exam information prior to their entry into the center. Those children with Medicaid/CHIP or dental insurance will be required to provide dental screening information (Go to step 6) prior to their entry into the center.
2)If the parent(s) and/or guardian does not have medical home or health insurance, the Health staff should provide and assist parents with the TexCare Medicaid/CHIP application. A copy of this application is saved in the health forms.
3)After the application is filled out, Health staff can assist parents by mailing or faxing the application to Midland, TX.
4)Follow-up should be done with families (every 4-6 weeks) until approval or denial is obtained. Head Start Health staff should document their work efforts on the child’s progress notes.
5)If the family is not eligible or chooses not to apply for Medicaid, Health staff should give the family the Head Start’s Community Resource and Health Directory to inform them of the providers in their community. Staff should document their work effort on the Medical Home Form or Parent Contact log.
6)When confirmation of the medical home is obtained, either via NHIC letter or verbally from the parent(s) and/or guardian, the Health staff should mark the appropriate boxes on the form. Staff must obtain a copy of the form scanned into the data system.
7)All work efforts must be documented on the medical home form of Parent contact log within five working days of receiving updated information. The total process should be completed within ninety (90) days of the child entering the center.
8)If there is a change of status with health insurance (no coverage, loss or denied health insurance), request parents to bring their documentation (denial letter, etc.) explaining reasons for the cancellation of services.Proof of this letter must be obtained in order for Head Start to pay for medical and dental services.
10)When children are transitioned into the school district, Health staff will confirm the medical home status during the exit interview. If there is a change of status, staff will provide a TexCare Application or provide Head Start’s Community Resource and Health Directory, refer parents to clinics in the community and document on the Health Summary form.
11)The month of February is “Follow-Up Month” with Medical Home status. This form should be updated on the data system, reflecting the “End of the Year” Status. Staff should document all work efforts on the Family Contact Log. If it is determined that a child does not have insurance, the Health staff will implement steps 2-5 in order to assist parent(s) fill out the TexCare application for health insurance and obtain a medical home.
RE-ENROLLMENT