Applications
Fillable Application Packets
EHS Application Packet 22/23 HS & GSRP Application Packet 22/23 HS Recertification Packet 22/23
Application Training Materials
Online Pre-Application
Staff responsible for taking applications will regularly check the pre-application Google sheet titled NMCAA 0-5 Program Interest Form to check for families interested in the program they work with. Staff will try to connect with families 3 times by phone call and text. If there is no response, staff will mail the Pre-App Follow Up Letter for Families and send out an email to try to make contact. Refer to the Maintaining Online Pre-App Guidance (2/22) for more information.
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Link to Pre-App that can be shared with families: https://docs.google.com/forms/d/e/1FAIpQLSeBRREv0bE2pfFNxKmx3WFjuEigbD5caRuY4BvAYpTA5C-lLg/viewform?usp=pp_url
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Pre-App QR Code:
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Before and After Lists for Parents
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EHS Center-Based Forms
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Intake Guidance and Support Materials
Families In Transition
When taking an application a family may bring up that they are in transition between housing or may feel uncertain about where they will be living. If the conversation seems to indicate the family may be in transition between homes, a Families in Transition Questionnaire can be completed and submitted to a McKinney Vento liaison along with a copy of the Disclosure With Parental Consent to determine eligibility under the McKinney Vento Act for homelessness. Both of these forms are a part of the application packet and will need to be copied and submitted to the McKinney Vento liaison assigned to the community the family lives in. Use the McKinney Vento Liaison List 19/20 to find the contact information of the liaison in your area. For more information see the McKinney Vento Flow Chart.
Health and Dental Forms and Releases
Medical/Dental Homes Guidance
While it is important to collect a fair amount of information and forms at time of application to identify eligibility, it is also important to begin the process of identifying needs with families. One piece in identifying needs is to consult with parents to determine whether each child has ongoing sources of continuous, accessible health care – provided by a health care professional that maintains the child’s ongoing health record and is not primarily a source of emergency or urgent care (HSPPS 1302.42). This includes both medical and dental homes.
Please see the following for how to enter this information accurately on the application and for CP entry.
While it is important to collect a fair amount of information and forms at time of application to identify eligibility, it is also important to begin the process of identifying needs with families. One piece in identifying needs is to consult with parents to determine whether each child has ongoing sources of continuous, accessible health care – provided by a health care professional that maintains the child’s ongoing health record and is not primarily a source of emergency or urgent care (HSPPS 1302.42). This includes both medical and dental homes.
Please see the following for how to enter this information accurately on the application and for CP entry.
- Dental and medical homes are only written on the application if the child has been seen by the dental or health clinic.
- If the dental and/or medical home is listed on the application, DMT will mark “yes” at enrollment for this child.
- If there is not a medical or dental home listed on the application “no” will remain on CP (PIR) “At Enrollment”.
- When an FSS or CCSC receive a WBC appointment date or dental appointment date for a child that did not have a medical home/dental home on their application, they must change CP (PIR) to Yes (At End Of Enrollment) because they found a medical/dental home while working in our program.
- If the FSS or CCSC sends for documentation of the appointment and it is found that the child was never registered as a client at the medical or dental home, staff must change CP (PIR) to No (At Enrollment) and No (At End of Enrollment). If staff gets a completed dental or WBC, Yes would be documented (At End of Enrollment)
- When staff enrolls a family, they will confirm the dental and medical home information is correct. If the medical/dental home information has changed since the time of application, the “At Enrollment” information in CP should be updated so this is correct.
Health Forms and Releases
EHS Child Development and Care Subsidy
Recertification
A recertification is used when a child was enrolled for the 2021-2022 school year as an eligible child, and the family intends for the child to return to a Head Start program. Children who were enrolled as 101-130% or over-income, children transitioning to a GSRP classroom, and children entering their 3rd year of HS will need new applications for the upcoming school year.
Recertification Packet 22/23
A recertification is used when a child was enrolled for the 2021-2022 school year as an eligible child, and the family intends for the child to return to a Head Start program. Children who were enrolled as 101-130% or over-income, children transitioning to a GSRP classroom, and children entering their 3rd year of HS will need new applications for the upcoming school year.
Recertification Packet 22/23