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Health

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Immunizations
Record of immunizations or an immunization waiver must be on file before a child can attend in-person programming.
The chart on the right outlines what immunizations are required and how many doses are required for each age group. Children can begin attending if they have 1 of each of these immunizations, but must be up-to-date or have a waiver or Doctors note in their file within 4 months of their first day of attendance as required by licensing R 400.8143 (3) and (4).


Entering in Child Plus:
Refer to the image on the right to locate the field for each item below:
  1. Enter all immunization dates in the Immunization tab. To enter multiple vaccines for the same date, enter the date in the box next to the number 1 and then click on the vaccine names below the box. You can also enter each one individually by typing the dates within the boxes.
  2. Select the appropriate choice from the Immunization Status At Enrollment drop down menu
  3. At the end of the program year, or when a child exits the program, select the appropriate choice from the At End of Enrollment drop down menu. If MCIR indicates that the child's immunizations are "Complete" then select Completed All For Age, even if Child Plus shows that the child has immunizations that are due/past due.
  4. Attach a copy of the MCIR report or Immunization waiver.
  5. Enter the name of the person responsible for tracking immunizations (Coordinator or FSS).
  • As immunizations are due throughout the year, update the immunization dates and attach a new record from MCIR.
Additional Information:
MCIR
Full Childcare Packet from DHHS-2020
Periodicity Table

Immunization Waivers
Families who do not immunize their children due to any reason must make an appointment with their local health department to complete an immunization waiver. Waivers must be completed and on file before a child can attend the classroom. Waivers expire after two years in most areas and after one year in Grand Traverse County. If a child transfers to a different center than the one designated on the waiver then a new waiver must be completed before the first day of attendance at the new center.
Physical Screens and Well Baby Checks
Collecting Physical Screens and Well Baby Checks
​After a child has been seen by a doctor for one of their required exams, send a copy of the 0-5 NMCAA Physical form along with the signed Health Release to the doctor office for completion and signature. If a doctor office does not return the 0-5 NMCAA physical form but sends a print out from their data system instead, you may need to send a NMCAA Program Physical Health Statement form for the doctor to sign. Licensing requires a doctor to sign a statement verifying that the child is physically and emotionally able to participate in a Head Start/Early Head Start classroom. *Visits to the doctor for sickness or injury do not count as well child checks or physical screens.

Time Limits
In accordance with licensing rule 400.8143 (6), the initial health record must be on file at the center within 30 days of a child's initial attendance and have been performed within 1 of the following time limits:
​                          (a) For an infant, within the preceding 3 months.
                          (b) For toddlers, within the preceding 6 months.
                          (c) For preschoolers, within the preceding 12 months.

Ongoing Schedules for Physical Screens and Well Baby Checks

Early Head Start
Well Baby Checks are due for the following months (The events in parentheses will automatically be added to the Well Baby Check events in Child Plus(CP). The bulleted items will have to be selected as separate events to enter into CP):
  • 2 months (Development, Physical)
    • Growth Assessment
    • Nutrition
  • 4 months(Development, Physical)
    • Growth Assessment
    • Nutrition
  • 6 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
  • 9 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
  • 12 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
    • Lead Screening
    • Anemia (Hemoglobin/Hematocrit)
  • 15 months (Dental Screen, Development, Physical)
  • 18 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
  • 24 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
    • Lead Screening
  • 30 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
  • 36 months (Dental Screen, Development, Physical)
    • Growth Assessment
    • Nutrition
Head Start
  • NMCAA staff will have a copy of children's most recent physical screen on file within 30 days of the child's enrollment date.
  • Well child checks will be renewed yearly.
  • The following events might be included in the Physical Screen information from the Dr. Add them as events when entering the Physical Screen.
    • Hearing
    • Vision
    • Growth Assessment
    • Blood Pressure
    • Anemia (Hemoglobin/Hematocrit)
    • Lead
BMI Screening and Follow Up for Head Start children and EHS children who are2 and up.
  • Head Start Teachers will complete height and weight measurements in September and May.
  • DMT will email Coordinators a list of children who are identified as having a BMI which falls at or below 5% and at or above 95%.
  • NMCAA staff or classroom teachers will follow up with the family for a face-to-face conversation to complete the BMI Follow-Up Form.

Hearing and Vision Screening

All children will be screened for hearing and vision within 45 days of enrollment. (EHS children who are under 6 months will have their vision screened as part of the ASQ since the vision screening equipment is not meant for children under 6 months.)
Use the Health Follow Up form to record any hearing, vision, blood pressure, or hemoglobin/hematocrit screenings that you complete. Share a copy of the Health Follow Up form with the child's family and record the events in CP.
                                                                                                           Health Follow Up
Re-screens
  • If a child fails their hearing screening, re-screen the child within 4-6 weeks.
  • If the child appears congested, re-screen hearing within 4-6 weeks.
  • Enter the re-screen information as an "Action" in CP under the original hearing event.
Referrals
If a child fails their vision screening or fails their hearing screening twice, refer the family to follow up with their health care provider or optometrist.
  • Any contacts with the family regarding the referral should be added as an "Action" under the hearing or vision screening event in CP.
  • After the child has been seen by a medical professional, ask the family to complete a release form and submit it to the Dr. office along with the Medical Follow-Up form.
  • Submit the completed Medical Follow Up form to DMT for entry into CP.
Instructional webinars, videos, and resources to share with families about hearing screenings can be found at the link below:

Dental Exam

All HS/EHS children over the age of one will complete a yearly Dental Exam.
HS- due within 90 days of enrollment.                           EHS- due at 12 and 24 months

When entering the event in CP, select Dental Exam (not dental screen).
  • If "Dental Exam Complete" is checked on the Dental Health Screening Record, then select the status of "Passed First Screening." Attach a copy of the form in CP.
  • If "Further Treatment Necessary" is checked, then send the Dental Health Screening Record to DMT for entry into CP. Attach a copy of the form in CP. Follow up with the family to encourage a treatment appointment if one has not been scheduled. Record any communication with the family as an "Action" under the dental exam event.

Blood Pressure, Lead, and Anemia (Hemoglobin/Hematocrit)

Blood Pressure
  • This might be found on the child's Physical Screen form from the Dr.
  • NMCAA staff can also complete a BP screening and record the score on the Health Follow Up form found above.
  • Enter the number on the "Results" line when entering the event in CP.
Lead Screening
  • These scores can be found in MCIR.
  • Scores of less than 5 are considered a "Pass".
  • Enter the number on the "Results" line when entering the event in CP.
  • Know the Facts lead information to share with families.
Anemia (Hemoglobin/Hematocrit)
  • This might be found on the child's Physical Screen or WBC form from the Dr.
  • NMCAA staff can also complete the screening and record the score on the Health Follow Up form found above.
  • Enter the number on the "Results" line when entering the event in CP.
Early Head Start Timelines
  • EHS children do not need a blood pressure screening.
  • Children will be screened for blood lead at 12 and 24 months.
  • Children will be screened for Hemoglobin/Hematocrit at 12 months.
Head Start Timelines
  • Blood Pressure screening will be completed within 45 days of enrollment. Updated yearly.
  • Lead screening will be completed within 90 days of enrollment. Only required once for entire duration of HS enrollment.
  • Hemoglobin/Hematocrit screening will be completed within 90 days of enrollment. Only required once for entire duration of HS enrollment.

Health and Dental Status Determination Dates

Early Head Start
  • Due within 90 days of child's first year of EHS enrollment.
  • Add the Hlth Stat Determ (EHS) event in CP by entering the date that the Physical Screening form was received. Mark the status as "Complete."
Head Start
  • Due within 90 days of child's HS enrollment each program year.
  • Add the Hlth Stat Determ Health event in CP by entering the date that the Physical Screening form was received. Mark the status as "Complete."
  • Add the Hlth Stat Determ Dental event in CP by entering the date that the Dental Health Screening Record was received. Mark the status as "Complete."

Federally Qualified Health Center

Some children receive health services at a "Federally Qualified Health Center." This information is something that is reported to the Office of Head Start in the Program Information Report (PIR). To help track this information, follow these steps:
  1. Figure out which children receive health services through a one of these centers. An easy way to see medical homes for all children on your caseload is to use report 3021 in Child Plus.
  2. Use the Health Center Program website on this page: https://bphc.hrsa.gov/about/index.html to find the Qualified Health Centers in your service area. Scroll down to the bottom of the page to find a search box.
  3. If any children use a Federally Qualified Health Center, change from No to Yes At Enrollment and At End of Enrollment for the question “Receive medical services through a federally qualified Health Center, Indian Health Service, Tribal and/or Urban Indian Health Program Facility. See image below.
Health Services Waivers
                 EHS Health Services Waiver                                              HS Health Program Services Waiver

Child Plus Entry

Entering Health Events
  1. In CP, select the Health > Events.
  2. You can enter events using either the Add Event tab or Add Multiple Events tab.
  3. Attach copies of all health event records on the Attachments tab.
Add Multiple Events
This option is helpful if you receive several health events that all happened on the same day such as from a physical screen.
  1. After selecting the Add Multiple Events tab, check the boxes next to all events that occurred on that day.
  2. Enter the Event Date, Status, Agency Worker, Provider Type, and Funding. (You have the opportunity to change all of this information for each event on the next page. For example, if the lead screening occurred on a different day than the rest of the events you could change the date of the lead screening.)
  3. Choose Next.
  4. All events that you checked on the first page will appear in a box in the upper left-hand corner. Choose each event from the list to make changes to the Event Date or Status for each event if needed at this time. Enter the appropriate information in the Results line for each event:
    1. Lead, Hemoglobin/Hematocrit, and Blood Pressure -enter the number value from screening
20/21 HS Dental Program Guideline
File Size: 73 kb
File Type: doc
Download File
20/21 HS Health Program Requirements
File Size: 2310 kb
File Type: rtf
Download File
EHS Authorization Memo
File Size: 35 kb
File Type: doc
Download File
HSPPS 1302.42 Child Health Status and Care
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