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6. Improve the health status of children
Approach for the Strategic Objective: For children enrolled in Head Start, provide access to regular medical and dental examinations, immunizations and required medical and dental treatments.
Program Description, Context, Legislative Intent and Broad Program Goals
Head Start emphasizes the importance of the early identification of health problems. Every child is in a comprehensive health program which includes immunizations, medical, dental, and mental health, and nutritional services.
The Head Start program has made a considerable investment in measuring program outcomes, particularly in the health areas. When this information is analyzed over time, it demonstrates that grantees are maintaining a high level of effort, especially in accomplishing a nearly 100% rate for child immunizations and rates approaching 90% or better for health and dental examinations and treatment. Head Start sees the need for improvement in the rates of treatment for mental health referrals and receipt of mental health services for children. Basic to the philosophy of the Head Start program is that healthy children will be better able to learn.
Head Start has measured health component outcomes for more than twenty years. Trend data over the past several years show that most Head Start grantees have maintained an acceptable level of performance in the area of health services. While not direct providers of health services, Head Start grantees assist families to access care by identifying health care providers and even providing families with transportation to and from health services. The newly revised Head Start Performance Standards require that every program help every child and family to identify a "medical home" which will provide the child with ongoing sources of medical care.
Every year Head Start polls approximately 1,525 Head Start grantees using the annual Head Start Program Information Report (PIR) survey to measure several health indicators, including immunization rates, screenings for health and dental health conditions, and the rates for accomplishing treatment for identified conditions. During the past several years Head Start has also measured the rate of referral and treatment for mental health conditions. The Summary Table below shows the results reported by all 1,525 reporting grantees since 1998. Generally, Head Start programs are maintaining acceptable results as shown on the table below for indicators measured.
Program-wide Performance
The summary table below compares the actual performance, as reported by 1,525 Head Start and Early Head Start grantees on the Head Start Program Information Report (PIR) for the reporting period ending in June 2000. Head Start devotes considerable time and energy to survey mailing, data collection, data cleaning, database building and data base management. These reports (more than 2400 reports were submitted) tracked performance for over 850,000 children in the FY 2000 reporting period.
Programs reported that 88% of enrolled children receive treatment for identified medical conditions. It is important to note that Head Start has a predictable turnover rate; that is, children leave the program during its course for various reasons. So while a referral may have been made, programs may not have follow-up information for children who have left the program.
Head Start health indicators (measures 6.1a-c) are below the target levels. Since Head Start program enrollees rely heavily on Medicaid services, the Head Start Bureau suspects that levels of reimbursements to providers, particularly dental health providers, are not sufficient to encourage the provision of services to Medicaid recipients. The result is that Head Start children experience delays in receiving such services. The Head Start Bureau will examine this and other possible causes to determine an appropriate national or local level response.
Dental treatment targets may be difficult to reach in the coming years as dental providers accepting Medicaid are scarce in some communities. This may also be a factor in mental health treatment for young children. Nevertheless, Head Start has chosen to continue target increases for performance indicators (measures 6.1a-c) for FY 2002 because health plays such a critical role in the overall positive development of children. The Bureau will examine the reasons why performance is below target projections and identify strategies and actions that are reasonable on a national level to increase these outcomes.
Summary Table
Performance
Measures |
Targets |
Actual Performance |
Reference (page # in printed document) |
|
|---|---|---|---|---|
| PROGRAM GOAL: Children in Head Start receive health and nutritional services. | ||||
| Objective: Children in Head Start receive needed medical, dental and mental health services. | ||||
| 6.1a. Increase the percentage of Head Start children who receive necessary medical treatment after being identified as needing medical treatment. | FY
02: 94% FY 01: 92% FY 00: 90% FY 99: 88% |
FY
02: FY 01 FY 00: 88%* FY 99: 87% FY 98: 88% |
Px M-99 | |
| *199,329 children were diagnosed as needing medical treatment and 175,504 received or are receiving treatment. | ||||
| 6.1b. Maintain the percentage of Head Start children who receive necessary dental treatment after being identified as needing dental treatment. | FY
02: 90% FY 01: 90% FY 00: 90% FY 99: 96% |
FY
02: FY 01 FY 00: 78%** FY 99: 81% FY 98: 83% |
Px M-99 | |
| **219,046 children were diagnosed as needing dental treatment and 170,828 received or are receiving treatment. | ||||
| 6.1c. Increase the percentage of Head Start children who receive necessary treatment for emotional or behavioral problems after being identified as needing such treatment. | FY
02: 85% FY 01: 83% FY 00: 81% FY 99: 81% |
FY
02: FY 01 FY 00: 77%*** FY 99: 75% FY 98: 75% |
Px | |
| ***46,256 children were referred for mental health treatment. 35,493 received treatment.. | ||||
Performance Measures for FY 2002 and Final Measures for FY 2001
PROGRAM GOAL: Children in Head Start receive health and nutritional services.
Objective:Children in Head Start receive needed medical, dental and mental health services.
6.1a. FY 2001: Increase from 88% in FY 1998 to 92% the percentage of Head Start children who receive necessary medical treatment after being identified as needing medical treatment.
FY 2002: Increase from 88% in FY 1998 to 94% the percentage of Head Start children who receive necessary medical treatment after being identified as needing medical treatment.
6.1b. FY 2001: Increase from 83% in FY 1998 to 90% the percentage of Head Start children who receive necessary dental treatment after being identified as needing dental treatment.
FY 2002: Maintain at 90% the percentage of Head Start children who receive necessary dental treatment after being identified as needing dental treatment.
6.1c. FY 2001: Increase from 75% in FY 1998 to 83% the percentage of Head Start children who receive necessary treatment for emotional or behavioral problems after being identified as needing such treatment.
FY 2002: Increase from 75% in FY 1998 to 85% the percentage of Head Start children who receive necessary treatment for emotional or behavioral problems after being identified as needing such treatment
Data sources: Head Start Program Information Report (PIR).
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