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gratefully acknowledges support for this educational activity from
gratefully acknowledges support for this educational activity from…
  • Improving Mental Health in Primary Care Through Access, Collaboration, and Training grant provided to the AAP through the Maternal and Child Health Bureau
  • Child Care and Healthy Partnership grant provided to the AAP through the Child Care Bureau and the Maternal and Child Health Bureau
  • Many colleagues
partnering to address mental health concerns in early education and child care

Partnering to Address Mental Health Concerns in Early Education and Child Care

Webinar brought to you by:

American Academy of Pediatrics

March 23, 2009

disclosures
Disclosures
  • We have no relevant financial relationships with the manufacturer(s) of commercial product(s) and/or provider of commercial services discussed in this CME activity.
  • We do not intend to discuss any unapproved/ investigative use of a commercial product/device in our presentation.
welcome

Welcome!

Marian Earls, MD, FAAP

Guilford Child Health Inc

Task Force on Mental Health

Section on Early Education & Child Care

Section on Developmental & Behavioral Pediatrics

gotowebinar attendee interface
GoToWebinar Attendee Interface

1. Viewer Window

2. Control Panel

general housekeeping tips
General Housekeeping Tips
  • All participants will be automatically muted throughout the presentation
  • At any time throughout the presentation, all participants are encouraged to ask questions using the question dialogue box I just showed you
  • During the Q & A period at the end of the presentation, I will recite questions and funnel the questions to the appropriate speaker to answer
  • Should you have any technical assistance questions during the event, please call 1-800-263-6317
outline of webinar
Outline of Webinar
  • Overview: Health Professionals Involved in Early Education and Child Care Regarding Mental Health Concerns
  • Bringing it All Together: The Importance of the Medical Home
  • Successful Start: Rhode Island’s Early Childhood Systems Plan
  • Office of Head Start: Early Childhood Development and Mental Health Concerns and the Role of Community Pediatric Clinicians
  • Wrapping it Up: How to Find and Connect with Local Health Consultants
  • Question & Answer Session
slide8

Overview: Health Professionals Involved in Early Education and Child Care Regarding Mental Health Concerns

Abbey Alkon, RN, PNP, PhD

UCSF School of Nursing

California Childcare Health Program

www.ucsfchildcarehealth.org

Section on Early Education & Child Care

us children in child care
US Children in Child Care

A majority of children less than 6 years old (60-70%) spend time in out-of-home child care.

Young children’s socio-emotional development is based on relationships.

Early identification of mental/behavioral and physical health problems can help children get needed services and be ready for kindergarten

Center on the Developing Children; Mental health problems in early childhood can impair learning and behavior for life. Working paper #6; 2008

9

us children in child care1
US Children in Child Care

12 million children: more than 9 million

are in licensed child care facilities.

105,444 child care centers.

213,966 family child care homes.

16,110 other licensed facilities.

About 3 million children are cared for in unlicensed and unregulated care.

10

background
Background

The most common health concerns for child care providers are:

Infectious diseases (for children < 2 years of age)

Challenging behaviors

Expulsion rates in child care are higher than elementary school

High child care staff turnover

Children need to be physically and mentally healthy to be ready to enter kindergarten

11

prevalence and risk
Prevalence and Risk
  • 13%-23% of preschool children have mental health problems.
    • Higher rate with the co-occurrence of other risk factors
  • Less than 1% of preschool children receive mental health services.

12

Raver, etal. 2008. ECRQ. Per Yoshikawa and Knitzer, 1977; Pottick & Warner, 2002.

social and emotional development in young children
Social and Emotional Development in Young Children

How they feel about themselves

Confident, secure,, eager to learn, proud of their culture versus always scared, afraid of being wrong

How they behave

Constantly fighting, easily upset, temper tantrums versus able to deal with conflict

Withdrawn, shy

Eating problems

How they relate to others

Especially people who matter to them, e.g., parents, teachers, and friends

National Center for Children in Poverty. www.nccp.org/pub_rps05.html

13

goals
Goals

14

Promote healthy physical and emotional development.

Identify early signs of emotional and/or behavioral difficulties.

health professionals involved in child care
Health ProfessionalsInvolved in Child Care

Child Care Health Consultants (CCHC)

Early Childhood Mental Health Consultants (ECMHC)

Primary Care Clinician (PCC)

15

slide16

Communication and the Medical Home

Primary CareClinician

Childand Family

Early Childhood Mental Health Consultant

Child Care Health Consultant

child care health consultants
Child Care Health Consultants

“A health professional who has interest in and experience with children, has knowledge of resources and regulations and is comfortable linking health resources with facilities that provide primarily education and social services”

Health Professionals: nurses, physicians, health educators, social workers, etc

Training: National Training Institute (train-the-trainer program)

Gold Standard: National Health and Safety Performance Standards (Caring for Our Children)

Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care, 2nd Edition, 2002.

17

child care health consultants job responsibilities
Child Care Health Consultants Job Responsibilities

Establish a trusting relationship

Conduct baseline needs assessment

Identify health problems to target for intervention

Develop or update written health policies

Provide workshops for child care providers and families

Provide regular telephone or email advice

Provide referrals to community services

Review health records

Develop care plans for children with special health care needs

18

impact of child care health consultation
Impact of Child Care Health Consultation

National health and safety standards (CFOC)

Increased # and quality of written health and safety policies

Medication administration, exclusion of ill children, care of mildly ill children, daily health check, emergency preparedness, and inclusion of children with special needs

Improved health and safety practices

consistent with CFOC

Emergency preparedness

Reduction in risk of SIDS

19

impact of child care health consultation continued
Impact of Child Care Health Consultation, Continued

Child Health Status

Immunizations up-to-date

Medical home

Health care plan for children with special health care needs

Health Insurance

The influence of child care health consultants in promoting children’s health and

Well-being: A report on selected resources. 2006.

http://hcccnsc.edc.org/resources/data/CC_lit_review_Screen_All.pdf

20

early childhood mental health consultants
Early Childhood Mental Health Consultants

Providers with mental health expertise and training on early care and education

“…collaborate with administrators, staff and family members of children from birth through 6 years of age participating in group care and early education settings…”

Builds staff capacity

To promote children’s social and emotional development

To address challenging behaviors

Brennan, EM, Bradley JR, Allen MD, Perry DF. (2008). The evidence base for mental health consultation in early childhood settings: Research synthesis addressing staff and program outcomes. Early Education and Development, 19(6): 982-1022.

21

early childhood mental health consultants1
Early Childhood Mental Health Consultants

Types of Consultation

Child- or Family-Centered Consultation

Programmatic Consultation

Focus on relationships

Staff and consultant, child, parent

Cohen, E., and Kaufmann, R. Early Childhood Mental Health Consultation. DHHS Pub. No. CMHS-SVP0151. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.

22

early childhood mental health consultants2
Knowledge of child development, normal growth and development, and ability to identify atypical behavior

Understand concepts underlying young children’s socio-emotional development

Observation, listening, interviewing, and assessment skills

Understanding of cultural differences

Ability to work with adults and knowledge of adult learning principles

Ability to recognize the diverse perspectives of staff and to facilitate communication of these perspectives

Knowledge of early childhood, child care, family support and early intervention systems, both public and private

Early Childhood Mental Health Consultants

Cohen, E., and Kaufmann, R. (2005).

23

consult with staff for children who may not succeed in school transition
Consult with Staff for Children Who May Not Succeed in School Transition

Engage in frequent fighting, shouting, or other aggressive behaviors

Are unable to control impulsive behavior

Are unable to pay attention to tasks or follow directions

Engage in oppositional, noncompliant, even defiant behavior

Are unable to cooperate with others

Constantly seek attention from peers or teachers

Ignore peers or teachers

Raver and Knitzer (2002) Ready to Enter: What research tells policymakers about strategies to promote social and emotional school readiness among three- and four-year-old children. National Center for Children in Poverty.

24

impact of early childhood mental health consultation
Impact of Early Childhood Mental Health Consultation

Review of 26 studies from 1985-2008 of staff and program outcomes (not child level)

Programs generally served urban, ethnically diverse children 2 to 5 years old

Results:

Staff increased self-efficacy/confidence and competence in dealing with troubling or difficult behaviors

Staff improved sensitivity and had lower job-stress

Improved overall quality of child care program

Reduced staff turnover

Brennan, EM, Bradley JR, Allen MD, Perry DF. (2008).

25

developmental screening of young children
Developmental Screening of Young Children

Where?

Primary care office

Child care

What screening instrument?

PEDS; www.pedstest.com

ASQ, ASQ- SE; www.pbrookes.com

ABLE; http://abletest.com

Others

How are results shared between PCC, child care provider, and child care consultants (CCHC, ECMHC)?

26

primary care clinicians
Primary Care Clinicians

Rosie D. Reforming the Mental Health System in Massachusetts. Center for Public Representation Web site. Available at: http://www.rosied.org/Default.aspx?pageId=67061. Accessed March 9, 2009

27

  • Primary care clinicians have a critical role to play in meeting children’s mental health needs. In fact, Massachusetts is now requiring, by court order, universal mental health screening by primary care clinicians for all children on Medicaid in that state.
  • Provide guidance to families
    • Help parents find high quality early care and education experiences for their children
    • Complete health forms and care

plans for children with special

health care needs

    • Communicate health issues and/or

treatment raised in PCC office or

child care program

primary care clinicians1
Primary Care Clinicians

Provide health consultation services to child care programs

Support child care in your local community to meet national standards for health and safety of child care for all young children.

Advocate for quality child care

State regulations to support health consultation

American Academy of Pediatrics. The Pediatrician's Role in Promoting Health and Safety in Child Care. Elk Grove Village, IL: American Academy of Pediatrics;

2001:25-27

28

bringing it all together the importance of the medical home

Bringing it All Together: The Importance of the Medical Home

Jack Levine, MD, FAAP

Section on Early Education & Child Care

Section on Developmental & Behavioral Pediatrics

the medical home a concept rather than a building
The Medical Home: A Concept rather than a Building

Accessible

Family-centered

Continuous

Comprehensive

Coordinated

Compassionate

Culturally Effective

successful early child care
Successful Early Child Care

Informed, activated family

Integrated, supportive community

Community resources and agencies

Medical Home

Based on Wagner et al.

integral part of community based system
Integral Part of Community-based System

Coordinates with community-based services designed to promote the healthy development and well being of children and their families

Facilitates access to and collaborates with a broad range of specialty, ancillary and related community services

slide33

Communication and the Medical Home

Primary CareClinician

Childand Family

Early Childhood Mental Health Consultant

Child Care Health Consultant

effective communication among health professionals
Effective Communication Among Health Professionals
  • Primary Care Clinician – Family – Consultant
  • Results of screening or initial evaluations
  • Reason for referral to mental health consultant
  • Share important medical information
  • Collaborate and cooperate on care plan for children
      • Medications
      • Emergencies
  • STAY INVOLVED!
communication with child care providers
Communication With Child Care Providers
  • Written communication
    • Clear language with no jargon
    • Write-out care plan and instructions
  • Appreciation for child care provider
    • Know children’s behavior in group situations
    • Experience with range of children’s behaviors
successful start rhode island s early childhood systems plan

Successful Start: Rhode Island’s Early Childhood Systems Plan

Susan Dickstein, PhD

Bradley/Hasbro Children’s Research Center

Brown Medical School

successful start rhode island s early childhood systems plan1
Successful StartRhode Island’s Early Childhood Systems Plan

Improved Outcomes for Children & Families

through

A More Effective Early Childhood System

slide38

Successful Start VISION

To create a comprehensive and coordinated early childhood system that supports families and communities in promoting positive early childhood development so that allchildrenenterschoolhealthyandreadytolearn.

Successful Start MISSION

To ensure that all young children reach their full potential through a system of services that promotes healthy social-emotionaldevelopment, quality earlycareandeducation, coordinated medicalhomes, and effective parenteducationandfamilysupport services.

slide39

Critical Components of

Early Childhood Systems

SOCIAL-EMOTIONAL COMPETENCE

Optimal Outcomes for Young Children and their Families

MEDICAL HOMES

EARLY CARE & EDUCATION

PARENT EDUCATION & FAMILY SUPPORT

slide40

Critical Components of Early Childhood Systems: Programs

SOCIAL-EMOTIONAL COMPETENCE

CCSN Early Learning Standards

CCHC EHS/HS

PEP/PBIS Early Intervention

Family Outreach Strengthening Families

Watch Me Grow KIDSCONNECT

Child Outreach Bright Stars (QRiS)

PPEP T.E.A.C.H.

FCCP IYS

LAUNCH Nurse Family Partnership

MEDICAL HOMES

EARLY CARE & EDUCATION

PARENT EDUCATION & FAMILY SUPPORT

mental health consultation to improve child care contexts
Mental health consultation to improve child care contexts

Child Care Support Network

Early Childhood

Mental Health Consultation

Funding provided by:RI Dept of Human Services,RI Dept of Health, and the

RI Maternal & Child Health Bureau

slide42

CCSN-Supported Activities

Classroom Outcomes

Child Outcomes

  • Child Social-Emotional Behavioral Functioning
  • Social-Emotional Competence at School
  • Behavior Regulation at School

Classroom observation and feedback to staff

Classroom Support

Program support

In-service training workshops of topics relevant to early childhood mental health

  • Classroom Functioning
  • CR Environment
  • CR Atmosphere
  • CR Quality
  • CR Behavior Patterns
  • Teacher Practices
  • Teacher Strategies
  • CR Map
  • Parent Involvement
  • Supervision practices
  • School Success:
  • Decreased suspensions & expulsions
  • Decreased mobility
ccsn mhc implementation questions pilot year 1
CCSN MHC ImplementationQuestions (Pilot Year 1)
  • How Were Child Care Centers Enrolled?
  • Who Participated?
  • How Did Classroom Observations Inform ECMHC Activities?
  • What ECMHC Activities were Implemented?A) Type?B) Amount?
how were child care centers enrolled
How Were Child Care Centers Enrolled?
  • Active Recruitment by RI Dept of Health
  • Priority to centers serving children with DHS child care subsidies
  • Eligible centers assigned to ECMHC for up to 12 months
  • ECMHC conducted on-site enrollment Interview
  • Collaborative plan to determine needs of the center; center “point person” for ECMHC; schedule of consultation services, etc.
  • Pre-ECMHC classroom observations scheduled & staff questionnaires completed
  • 2-session workshop training scheduled (based on CSEFEL principles)
slide45

Age range (months)

# classrooms

# children

# staff

Center 1

0-60+

5

50

10

Center 2

0-60+

4

47

11

Center 3

36-60

1

25

6

Center 4

0-36

4

27

10

Center 5

0-36

7

84

29

Center 6

36-60+

2

45

14

TOTALS

23

278

80

2. CCSN MHC Pilot Yr 1: Who Participated?

how did classrooms observations inform ecmhc activities
How did Classrooms Observations Inform ECMHC Activities?
  • Classroom observations in every classroom by evaluation team using standardized tools
  • Clinical feedback provided to ECMHCs
  • ECMHC worked with program to incorporate feedback into consultation plan and ongoing consultation activities
what ecmhc activities were implemented
What ECMHC Activities were Implemented?

Classroom Support

  • Consultation- classroom, child, or family concerns
  • Classroom improvement plans
  • Program enhancements for challenging behaviors and/or developmental concerns
  • Communication with parents about child behavior/development
  • Community-based referrals

Program Support

  • Case management reviews
  • Reflective supervision practices
  • Team building
  • Workshop Trainings
summary of pilot year 1 direct ecmhc activities
Summary of Pilot Year 1 Direct ECMHC Activities
  • Most (83%) MHC activities were conducted at the classroom support level (ranging from 57-97%)
  • Some (11%) MHC activities were conducted at the program level (ranging from 3-25%)
  • 5/6 programs participated in the 2-session workshop series
engagement with ecmhc activities
Engagement with ECMHC Activities
  • On-site Consultation: Average rating of satisfaction with MHC activities=4.36 on scale from 1(low) to 5 (high)
  • MHC Workshops: 94% participants reported strong agreement with stated learning objectives (e.g., I can describe how classroom environments support child development, etc.)
evaluation questions
Evaluation Questions

Were there pre-post ECMHC changes in:

  • classroom functioning?
  • teacher practices?
  • program supervisory practices?
  • rate of expulsion from child care centers?
classroom functioning
Classroom Functioning?
  • Environment (space, care routines, interactions, activities, structure, parent involvement)
  • Quality (general functioning)
  • Atmosphere (child compliance, cooperation, interest, enthusiasm in classroom activities)
  • Behavior Disruptions during routine daily transitions (very challenging in most child care settings)
classroom environment
Classroom Environment?

Overall, ECERS/ITERS Total Scores* showed statistically significant improvement from pre-ECMHC (mean=3.67, sd=.57) to post-MHC (mean=4.08, sd=.62)*(scale: 1=inadequate, 3=minimal, 5= good, 7=excellent)

Classroom Quality?

Classroom PIRS Total Scores* showed small to moderate improvement (about 1/2 sd) from pre-ECMHC (mean=3.31, sd=.55) to post-ECMHC (mean=3.06, sd=.69)

* (lower scores are positive)

classroom atmosphere
Classroom Atmosphere?

Classroom Atmosphere Total Scores* showed no substantive change from pre-ECMHC (mean=3.13, sd=.60) to post-ECMHC (mean=3.20, sd=.78)

(*lower scores indicate better child emotional adjustment in the classroom)

Classroom Behavior Problems?

Classroom Situations Scores showed overall decrease in frequency of behavior disruptions during classroom transitions from pre-ECMHC (about 7 transitions with moderate to severe behavior disruptions) to post-ECMHC (about 5 transitions with moderate to severe behavior disruptions)

teacher practices
Teacher Practices?
  • Self-reports by teachers generally showed small to moderate improvements in several areas:a) Confidence (significant change)b) Use of Positive Strategies (.35 sd change)c) Use of Praise (.63 sd change)d) Effective Limit Setting (.50 sd change)
program supervision practices
Program Supervision Practices?

Average rating of teacher satisfaction with supervision received by program supervisors showed small to moderate improvement (about 1/3 sd) from pre MHC (mean=3.99, sd=.77) to post MHC (mean=4.23, sd=.67)

rate of expulsion from child care centers
Rate of expulsion from child care centers?

“People working in the fields of child care and early childhood education knew there was a problem when a number of children as young as 3 were getting booted out of preschool because of disruptive behavior”.

K. Shaw (2003)

national preschool expulsion rates gilliam 2005
National Preschool Expulsion Rates(Gilliam, 2005)
  • Average 3x higher than those of K-12.
  • Overall, for every 1,000 children in pre-K, 6.7 children are expelled.
preventing preschool expulsion mental health consultation
Preventing Preschool Expulsion: Mental Health Consultation
  • Access to early childhood mental health consultation is associated with lower rates of expulsion from pre-K
  • On-site access to a psychologist or social worker expelled 5.7 children per 1,000
  • Lack of access to early childhood mental health consultation expelled children at the highest rates of 10.8 per 1,000

(Gilliam, 2005)

may reduce risk of preschool expulsion by
May Reduce Risk of Preschool Expulsion By:
  • Enhancing skills of early care and education providers in behavior and classroom management;
  • Increasing developmentally appropriate practices and expectations;
  • Reducing staff stress and turnover;
  • Reducing levels of problematic behavior in young children;
  • Enhancing early identification of problem behaviors;
  • Supporting the child care community, families, and children who are manifesting (or are at-risk for) problematic behaviors

(Brennan, 2005; Perry, 2005)

impact of ecmhc on pre k expulsion rate 6 ccsn pilot year 1 mhc centers
Impact of ECMHC on Pre-K Expulsion Rate: 6 CCSN Pilot Year 1 MHC Centers?
  • In year prior to ECMHC, these 6 pilot centers reported 4 expulsions = 16 per 1000 = 2 ½x national average
  • In year during ECMHC, these 6 centers reported 2 expulsions = 7.8 per 1000 =closer to national average & lower than the RI average
  • Centers reported 50% fewer expulsions from pre- to post-ECMHC
  • …Promising!
how is the ccsn mental health consultation program sustained
How is the CCSN Mental Health Consultation Program Sustained?

Futures Directions of ECMHC in RI:

  • RI Association for Infant Mental Health (RIAIMH) to address workforce development issues in training front line professionals in principles of Early Childhood Mental Health; and in establishing standards/credentialing for consultants
  • Bright Stars (quality rating improvement standards for child care) to link with ECMHCs
  • Project LAUNCH
  • Workgroup Established for Integration and Financing for Children’s Developmental and Mental Health Services within Primary Care and Child Care Settings
slide62

RI LAUNCH: Building on the Successful Start Results-Based Framework

Inputs & Resources Core Components Infrastructure Change Outputs Outcomes

Successful Start

Statewide

Early Childhood Systems Building

·  Infrastructure, Organization, & Partnerships

·  Early Childhood Systems Plan

·  Implementation of Project & Strategic Plan Goals

  • Diminished Service Delivery Boundaries
  • Organized Management Structure
  • State, Academic, Community, Family Partnerships
  • State Financing
  • Third Party Financing
  • Cross-Sector Goals
  • Sector-Specific Goals
  • Systems Capacity
  • Quality of Services
  • Service Integration
  • State & Community Policy Change
  • Program Evaluation

AllChildren Healthy &Ready to LearnEarly childhood & family services that promote healthy early childhood physical, cognitive, and emotional development

Parent Education & Family Support

Early Care & Education

Medical Homes

Social-Emotional Development

launch setting providence ri
LAUNCH Setting:Providence, RI
  • Rhode Island is smallest state geographically, 1.2 million residents
  • Providence is capital city, population 173,600 with 26,700 children 1-8 years
  • Latino (Puerto Rican, Dominican) and African American most prominent racial-ethnic groups (approx 75% minority in Providence)
  • 51% single parent; 28% < HS education; 43% living in poverty
goal 1 ecmhc in primary care settings
Goal 1: ECMHC in Primary Care Settings
  • Integrate developmental and behavioral health screening in medical homes
  • Locate mental health consultants in pediatrician offices where screening is implemented to establish follow up; assessment; and targeted intervention
goal 2 link parent support and education in primary care
Goal 2: Link Parent Support and Education in Primary Care
  • Assess parent and family functioning in primary care linked to developmental screening
  • Implement empirically validated parenting intervention for targeted families (VIPP; IYS)
  • Identify third-party reimbursement mechanisms for empirically validated parenting interventions
goal 3 consultation in child care settings
Goal 3: Consultation in Child Care Settings
  • Implement mental health consultation in child care; integrated with developmental screening
  • Implement empirically validated classroom behavior management training for staff in child care (IYS CBMS)
  • Implement empirically validated parent training for targeted families (VIPP; IYS)
  • Identify third-party reimbursement mechanisms for child/family assessment and empirically validated parenting interventions
challenges
Challenges
  • Minimize extent to which current programs work in silos
  • Develop referral resources beyond consultation for identified children (0-8) and their families
  • Develop sustainable funding mechanisms
  • Establish standards/competencies for professionals in early childhood fields; and for child care quality
opportunities
Opportunities
  • Training opportunity for early childhood professionals
  • State government – academic partnership
  • Alignment with multiple state initiatives for improving children’s behavioral and physical health
for more information
For More Information

Susan Dickstein, PhD

401-793-8731

Susan_Dickstein@brown.edu

Kristine Campagna, MEd

401/222-5927

Kristine.Campagna@Health.ri.gov

Special thanks to CCSN Early Childhood Mental Health Consultants at:

Bradley Early Childhood Clinical Research Center/Brown Medical School

Providence Center Early Childhood Institute

slide70

Office of Head Start: Early Childhood Development and Mental Health Concerns and the Role of Community Pediatric Clinicians

Barry Marx, MD, FAAP

Senior Medical Advisor, Office of Head Start

office of head start mission statement
Office of Head StartMission Statement

“To promote school readiness by enhancing the social and cognitive development of children through the provision of educational, health, nutritional, social and other services to enrolled children and families.”

early childhood development health services
Early Childhood Development & Health Services

Commitment to Wellness

To ensure a comprehensive vision of health for children, families, and staff.

Objective

To ensure that, through collaboration among families, staff, and health professionals, all child health and developmental concerns are identified, and children and families are linked to an ongoing source of continuous, accessible care to meet their basic health needs.

head start performance standards
Head Start Performance Standards

Child mental health services

  • Collaborative relationship between agencies and families
  • Secure necessary mental health services
  • Regular schedule of on-site mental health consultation involving the mental health professional, program staff, and parents

Human resources management

  • Staff consultants must meet standards for qualified candidacy
  • Mental health consultants must be licensed or certified mental health professionals with relevant experience
head start information report
Head Start Information Report*
  • Total actual enrollment: 1,061,275
  • Health insurance:
    • At enrollment: 927,094
    • At end of enrollment year: 990,189
  • Medical Home:
    • At enrollment: 928,553
    • At end of enrollment year: 1,007,550

* From 2006-2007

head start information report medical services
Head Start Information Report Medical Services
  • Up-to-date on a schedule of age-appropriate preventive and primary health care, including all appropriate tests and physical examinations: 954,277
  • Diagnosed as needing medical treatment (of the children screened): 186,957
  • Received or are receiving medical treatment (of the children diagnosed): 174,435
head start program information report screening
Head Start Program Information Report: Screening

Screening – Developmental, sensory, behavioral

  • Completed screening for developmental, sensory and behavioral concerns: 941,484
  • Identified as needing a follow-up assessment or formal evaluation: 124,654
head start program information report mental health mh services
Head Start Program Information Report: Mental Health (MH) Services

Mental health professional…

Consulted with program staff about the child’s behavior or mental health: 143,458

  • Provided 3 or more consultations with program staff during the operating period: 47,384
  • Consulted with the parent(s) / guardians(s) about their child’s behavioral and/or mental health: 60,881
  • Provided an individual mental health assessment: 69,008
  • Facilitated a referral for mental health services: 31,251
head start program information report mental health mh services1
Head Start Program Information Report: Mental Health (MH) Services

Children who were…

  • Referred for MH services outside of program: 22,752
  • Received MH services: 16,765
collaboration to address children s mental health needs in head start
Collaboration To Address Children’s Mental Health Needs in Head Start
  • Head Start Mental Health Consultant (MHC) and/or staff refers to PCC for evaluation and/or treatment
  • PCC communicates a behavioral/mental health plan of care to Head Start staff
  • Head Start MHC and/or staff collaborate to assist family (eg, referrals, ongoing care plan) in additional ongoing needs
  • PCC and Head Start staff share information about resources and service availability
  • Health professionals (eg, PCC, MH Professionals) shape the programs’ delivery of health services through participation on the Head Start Health Services Advisory Committee
head start health services advisory committee
Head Start Health Services Advisory Committee
  • Links Head Start programs to essential persons, organizations, and resources within the community
  • Plays an important role in ensuring that Head Start children have medical and dental homes that will remain in place after they leave the program
  • Plays an integral part in the development of health policies and procedures for Head Start programs
head start health services advisory committee1
Head Start Health Services Advisory Committee

Participants on the HSAC may include, but are not limited to:

􀁺 Pediatricians

􀁺 Nurses

􀁺 Nurse practitioners

􀁺 Dentists

􀁺 Nutritionists

􀁺 Mental health providers

􀁺 Women, Infants, and Children

(WIC) program staff

􀁺 Medicaid and SCHIP staff

􀁺 Head Start parents

􀁺 Head Start staff

head start and community pediatric clinicians
Head Start and Community Pediatric Clinicians
  • Head Start staff and programs serve children, families and communities in the greatest need.
  • Collaboration between Head Start programs and community providers of pediatric health care strengthens both systems of care, and enriches the lives of staff, children, families, and communities.
for more information1
For more information

Barry Marx, MD, FAAP

Senior Medical Advisor

Office of Head Start

Barry.Marx@acf.hhs.gov

Office of Head Start Web site

http://www.acf.hhs.gov/programs/ohs/about/index.html#mission

Head Start Program Performance Standardshttp://eclkc.ohs.acf.hhs.gov/hslc

Committee on Community Health Services

The Pediatrician’s Role in Community Pediatrics

Pediatrics 2005;115:1092–1094

http://aappolicy.aappublications.org/cgi/reprint/pediatrics;115/4/1092.pdf

wrapping it up how to find and connect with local health consultants

Wrapping it Up: How to Find and Connect with Local Health Consultants

Marian Earls, MD, FAAP

Guilford Child Health Inc

Task Force on Mental Health

Section on Early Education & Child Care

Section on Developmental & Behavioral Pediatrics

find and connect with your local health consultants
Find and Connect with your Local Health Consultants

Healthy Child Care Consultant Network Support Center (NSC) http://hcccnsc.edc.org/

  • Registry of CCHCs
  • State profiles (contact CCHC coordinator)

Are you a CCHC?

Add your name to the NSC registry!!!

find and connect with your local health consultants1
Find and Connect with your Local Health Consultants

- National Training Institute for Child Care Health Consultants (train-the-trainer program) http://nti.unc.edu

  • Contact NTI to find local CCHCs who have been trained by an NTI graduate

- National Association of Child Care Resource & Referral Agencies (NACCRRA) www.naccrra.org

  • Enter zip code to find local CCR&R
  • This agency can help you connect with local ECMHCs

- National Technical Assistance Center for Children's Mental Health

Georgetown University Center for Child and Human Development

Georgetown University

http://gucchd.georgetown.edu/programs/ta_center/contact/contact.html

question answer session
Question / Answer Session
  • Please type in your questions in the chat log located on your control panel.
  • The phone lines for the panel members will be open at this time.
  • The moderator will select questions from the chat log and the panel members provide answers.
thank you for participating
Thank You for Participating!

This Webinar has been recorded

and will be posted online, along with a complete resource list, at:

www.aap.org/mentalhealth

www.healthychildcare.org