1 OHS HSPPS Wednesdays Office of Head Start Head Start Program Performance Standards (HSPPS) January 18, 2017 ANN Welcome participants to today’s event.

2 Today’s Agenda Welcome Hot Topics Monthly Focus Resources Wrap UpHealth, Safety and Mental Health Resources Wrap Up [ANN] A walkthrough of today’s OHS HSPPS Wednesday for Federal Staff Agenda.

3 JANUARY’S HOT TOPICS

4 Question and Response ProcessJanuary Hot Topics Background checks PI and FAQs published in December Question and Response Process Submitted through the ECLKC Responses sent to more than half of submitted Qs Some Qs require broader guidance, which Central Office is working with the National Centers to develop. [COLLEEN & BETH] Colleen and Beth to discuss hot issues this month. Background check – review PI & FAQs published in December Question & Responses on HSPPS Remember to send all questions to the ECLKC – in the ‘Contact Us’ Button at the top of the page

5 Health, Safety, and Mental HealthMarco Beltran & Sangeeta Parikshak, Office of Head Start and Early Childhood Development, ACF, HHS

6 Sections Purpose. Collaboration and communication with parents. Child health status and care. Oral health practices. Child nutrition. Child mental health and social and emotional well-being. Family support services for health, nutrition, and mental health. Safety practices. Health Program Services Purpose. Collaboration and communication with parents. Child health status and care. Oral health practices. Child nutrition. Child mental health and social and emotional well-being. Family support services for health, nutrition, and mental health. Safety practices.

7 Health Program Services ThemesThe core health services from the previous program performance standards were maintained Strengthened the requirements with an emphasis on oral health and parent education in health issues We updated the mental health requirements We also streamlined program performance standards The previous standards in Part 1304, Subpart B; Portions of Part 1304, Subpart D; Part 1306, Subpart C; and , are now Subpart D. We updated, reorganized, and streamlined the requirements in order to make the rules easier to find, follow, and implement. We moved the sections related to education, and developmental screening and assessment into Subpart C of part 1302, Education and Child Development Program Services. We moved language regarding individualization of services into Subpart F of 1302, Additional Services for Children with Disabilities, as well as Subpart C. The entire Health Program Services Subpart was reorganized for the sake of transparency, clarity, and improved implementation. Why did we make these changes? Because the previous Early Childhood Development and Health Services Subpart confused users and did not clearly delineate services, or outline the chronological steps programs are required to take to deliver those services. To remedy this confusion, we restructured the Early Childhood Development and Health Services Subpart to clearly delineate the steps that will ensure that programs deliver services that promote the overall health of all children. We retained and streamlined a majority of the policy requirements under the existing Subpart. Specifically, we retained the core health services, including hearing and vision screening, ongoing care, and follow-up care as required by the Act (42 U.S.C. 9831). We retained these requirements both because the Act clearly links health, mental health, and nutritional services to the purpose of Head Start, and because research has demonstrated a strong link between child health, school readiness, and long-term outcomes. The most substantial changes are in: Child health status and care Child mental health and social and emotional well-being Family support services for health, nutrition, and mental health Safety practices We added several important additions. Specifically, we highlight oral health and parent education in health more explicitly by creating new sections that outline requirements in each of these areas. Also we strengthened provisions to better reflect best practice and to ensure that mental health services are used to improve classroom management and to effectively address challenging behaviors when they arise.

8 Goals in the Implementation of the new HSPPS Regarding Mental HealthSupport programs in creating a culture that promotes positive mental health and social and emotional well-being Reduce the prejudice and discrimination around mental health services Improve parent and staff understanding of what mental health means for children as well as adults Empower programs to know how to handle challenging behaviors Improve classroom management

9 1302.17 Suspension and ExpulsionGoal: Codifies long standing practice to not expel children from Head Start programs NEW section in HSPPS Prohibits expulsion and severely limits suspension Provides steps for programs related to challenging behaviors Elaborates on engaging mental health consultants described in mental health and social and emotional well being regulation •This new regulation codifies long-standing practice to not expel children from Head Start Programs •Specifically it prohibits expulsion and severely limits suspension and instead focuses on ways to keep children in the program even in the face of challenging behaviors. •It outlines what a program must do to determine whether a temporary suspension is necessary including engaging a mental health consultant, collaborating with the parents, and utilizing appropriate community resources. •By engaging mental health consultants early in the process and collaborating with the parents, along with , which is mental health and social and emotional well-being, integrate preventive efforts to address problem behaviors while also supporting families and staff when challenging behaviors arise. •The new rule also outlines what a program must do to help the child return to full participation in all program activities as quickly as possible if a temporary suspension is indeed deemed necessary, including documenting the action and supports needed, providing home visits, and determining whether it is appropriate to refer the child to a local agency responsible for implementing IDEA. •This section specifically underscores that if a child qualifies for IDEA services or for services and supports under Section 504 of the Rehabilitation Act (i.e.,does not satisfy the definition of disability under IDEA for the state but does satisfy the definition in the Rehabilitation Act), that the child should not be excluded from the program. •The rule does allow for flexibility in that if a program has explored all possible steps as outlined and documented all steps taken, and it is determined the program is not the most appropriate placement for the child, the program must work to directly facilitate the transition of the child to a more appropriate placement.

10 Purpose Goal of the health section is to ensure programs provide high-quality health, oral health, mental health, and nutrition services that support each child’s growth and school readiness Section  Purpose Health Program Services Subpart D now contains a “purpose” statement that explicitly states the goal of the Subpart, which is to ensure that programs provide high quality health, mental health, and nutrition services; and the purpose of such services, which is to support each child's growth and school readiness.

11 1302.41 - Collaboration and communication with parentsRequires programs collaborate and communicate with parents about their children’s health in a linguistically and culturally appropriate manner and communicate with them about health needs and concerns in a timely manner. Program requirements for advance authorization from parents and for sharing policies for health emergencies. Section  Collaboration and Communication with Parents We believe communication and collaboration with Head Start parents is fundamental to the delivery of all Head Start health services. The reason we placed this section at the forefront of this Subpart is because we wanted to better communicate its importance to programs and the public. The requirement for programs to communicate and collaborate with parents with regard to their children's health is written to reflect the applicability and importance of parental communication, collaboration, permission, and input for the services described throughout the entire Health Subpart. This section was developed from what previously used to be (e) and (b)(4), and concepts from (a)(1). Some of these concepts are also represented, with regard to parent education services in (Family Support Services for Health, Nutrition, and Mental Health). Paragraph (b)(2) is new and requires programs to share policies for health emergencies that require rapid response or immediate medical attention.

12 1302.42 - Child Health Status and CareDetermine children’s source of care Support parents in ensuring children are up-to-date and ensure children receive ongoing necessary care Determine if children have health insurance and supports families in accessing health insurance if they do not Requirements for extended follow-up care and clarifies use of program funds for medical and oral health services. Use of funds for the provision of diapers and formula Child health status and care. This section includes requirements for programs to determine children’s source of care, to support parents in ensuring children are up-to-date for preventive and primary medical and oral health care, and to support parents to ensure children receive ongoing necessary care. It also requires programs to determine if children have health insurance and supports families in accessing health insurance if they do not. (Detailed explanation) Section  Child Health Status and Care We felt that the previous did not make the required services, or the chronological order of the steps within those services, clear. (It combined requirements related to extended follow-up and care with those of initial screening and ongoing care.) is designed to clearly delineate the steps in determining “a child’s health status and needed care.” In paragraph (a), within 30 calendar days, programs must determine whether each child has an appropriate source of ongoing care and health insurance coverage and, if not, assist the parents in accessing each. In paragraph (b), within 90 days, programs must determine whether children are up-to-date on schedules of immunizations and well-child care, and, if not, assist parents in getting children up-to-date or if necessary, directly facilitate the provision of health services for children with parental consent. OHS believes that the requirement for the program to directly facilitate health services, if necessary, is central to ensuring all children are up-to-date, especially with critically important vaccinations. Under paragraph (b)(2) programs must ensure children are screened for health problems, including visual and auditory concerns. Finally, in paragraph (c)(2), programs must monitor the implementation of follow-up care and monitor children for new and/or recurring health problems. Each of these four steps was required previously but their individual roles, as well as their order, was difficult to decipher. The explicit inclusion of health insurance in paragraph (a) also codifies long-standing practice, since linking families with health insurance is a critical step in helping link them with providers, but, given the increased availability of coverage, we think being explicit on this requirement is important. We maintain each of these steps because research has shown that children who participate in a consistent schedule of well child care and immunizations are more likely to stay healthy and engage in program activities, leading to improved school readiness. Hence school readiness begins with health. So, what did we do to the previous standards outside of reorganizing them? We reduced the timeframe for determining whether a child has an appropriate source of health care to 30 days. We still give programs 90 days to assist parents in accessing such a source of care and to ensure children are up to date with Early Periodic Screening, Diagnosis, and Treatment (EPSDT). We do, however, specify that an appropriate source of ongoing care cannot operate primarily as an emergency room or urgent care facility, because research has shown that families who have an ongoing source of continuous care are more likely to attend well child visits, know what to do when their child is sick, and seek appropriate care for illnesses or health concerns. (Note: Many people think that the following is new but it is not: In paragraph (b)(3) if a program operates less than 90 days, they have 30 days from the day the child first attends the program to determine if the child is up to date (assist parents to bring the child up to date if necessary) and obtain or perform vision and hearing screenings.) Because developmental screening is closely related to educational services we moved developmental and behavioral screenings to Subpart C of (Child Screenings and Assessments). We retained sensory screenings and other health related diagnostics tests, including those related to nutritional status, in this section because these screenings and tests must be included in high quality health service delivery. We also moved and revised the requirements that such screenings be sensitive to each child's background ( (b)(1)) to (c)) into Subpart C to reflect that this is a core characteristic of an appropriate screening or assessment. In paragraphs (d) and (e), we moved and revised requirements related to ongoing care and extended follow up and treatment from §§  and in the previous rule for clarity and transparency. What used to exist in (f) (Individualization of the Program) has been moved to the section on Additional Services for Children with Disabilities as well as the Education and Child Development Program Services Subpart. Given these moves we determined that health services are individualized by design, and thus what used to exist in (f) was no longer relevant in Subpart D. Finally, we clarified the use of program funds for medical and oral health services as well as the provision of diapers and formula.

13 Vaccination QuestionsCan the program deny enrollment for a child that doesn’t have his/her vaccines? Where in the standards does it indicate that a child without vaccinations cannot be enrolled in the program? Where in the new standards is the information regarding vaccines or a history of immunology? State rules require immunization records for attendance at Head Start within 30 days upon entry or attendance cannot continue, but Head Start administrators have said that because of federal funding for the Head Start they are not able to prohibit attendance under any circumstances. Can you confirm this and cite the statue or rule that applies? Question 1: Response Sent: Generally, the HSPPS defer to state requirements regarding immunizations and enrollment.  The requirement at (e) states “A program must comply with state immunization enrollment and attendance requirements, with the exception of homeless children as described in (c)(1).”  In addition, the standard at (c)(1) requires programs to allow homeless children to attend without immunization or other records for up to 90 days or as long as allowed under state licensing requirements: “If a program determines a child is eligible under § (c)(1)(iii), it must allow the child to attend for up to 90 days or as long as allowed under state licensing requirements, without immunization and other records, to give the family reasonable time to present these documents. A program must work with families to get children immunized as soon as possible in order to comply with state licensing requirements.” Question 2 Response (sent): Please see (e) in the new Head Start Program Performance Standards, which states “A program must comply with state immunization enrollment and attendance requirements, with the exception of homeless children as described in (c)(1).”

14 Dental Exam Questions How often do dental exams and blood tests need to be updated? Following current EPSDT requirements for state (are more rigid than new HSPPS). Response Sent: Head Start programs rely on state EPSDT requirements, which can be referenced at the following link:   https://eclkc.ohs.acf.hhs.gov/hslc/states/epsdt The requirements regarding “Child health status and care: Ongoing care” are found at (c)(1)-(3) and state: (1) a program must help parents continue to follow recommended schedules of well-child and oral health care; (2) A program must implement periodic observations or other appropriate strategies for program staff or parents to identify any new or recurring developmental, medical, oral, or mental health concerns; and (3) A program must facilitate and monitor necessary oral health preventive care, treatment, and follow-up, including topical fluoride treatments. Programs should develop appropriate schedules for children’s medical and dental updates based on the state EPSDT requirements and any additional recommendations of the program’s Health Service Advisory Committee.

15 Facilitating Fluoride Questionc(3) indicates that programs must facilitate fluoride supplements and other necessary preventative measures.  Are the standards stating the programs must provide fluoride supplements to children if the service area lacks fluoride, along with other preventative measures such as using fluoridated toothpaste? Response Sent: The performance standard at (c)(3) states: A program must facilitate and monitor necessary oral health preventive care, treatment, and follow-up, including topical fluoride treatments.  In communities where there is a lack of adequate fluoride available through the water supply and for every child with moderate to severe tooth decay, a program must also facilitate fluoride supplements, and other necessary preventive measures, and further oral health treatment as recommended by the oral health professional. The standard does not say “must provide” but says “must facilitate and monitor.”  Thus, programs are not required to directly provide fluoride supplements, but rather have a responsibility to facilitate access to fluoride supplements where necessary.  Further, while a program is not required to directly provide fluoride supplements, they may choose to do so based on the recommendations of their Health Service Advisory Committee (HSAC). The standard provides programs flexibility to determine the most appropriate way to meet the needs the needs of the children and families being served based on the circumstances of their community.  A grantee should use relevant data, for example, in this case, information about availability of fluoride in the water supply, oral health status of the children enrolled in the program, and recommendations of the program’s oral health professional to shape decisions about the level and type of preventive oral health measures and treatments necessary to meet the Standard. Programs should also consult the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Guidelines and the dental periodicity schedules for their state in order to understand any minimum requirements for the oral health care of the population being served by the program.  https://eclkc.ohs.acf.hhs.gov/hslc/states/epsdt

16 1302.43 - Oral Health PracticesPromote effective oral health hygiene with daily tooth brushing Direct/clear from previous instruction where we said that staff must promote effective dental hygiene among children in conjunction with meals Oral Health Practices In this section, we describe the oral hygiene requirements during program hours. The requirements in this section are not new. We simply moved and revised the previous standards ( (b)(3)), to more accurately reflect the expectations for hygiene practices upon which programs are monitored, namely ensuring children brush their teeth once during program hours. While the previous standards specified that oral hygiene should be promoted in conjunction with meals, we removed this concept to give programs greater flexibility to determine how best to meet this requirement. Research has documented a link between oral health, and specifically dental pain, and children's attendance in preschool programs, as well as their ability to effectively engage in classroom activities.

17 Child Nutrition Includes requirements related to how much food should be offered Requirements for supporting breastfeeding Requirements about use of funds. Making safe drinking water available to children during the program day is something that did not exist in our current standards under nutrition Child Nutrition: Under section 641A(a)(1) of the Act, the Secretary must establish performance standards with respect to nutritional services. To implement this requirement, as with other sections of this Subpart, we retained the majority of the requirements of the previous standards in this section, although we reorganized them. We restructured the child nutrition section to solely reflect nutritional services programs provide directly to children, and as a result, we maintained the provisions contained in (b), as well as (c)(5) and (6). We moved and restructured (a) and (b)(4) so that all nutritional assessments are incorporated into child health status, because nutritional status is an integral part of child health status. We also moved (c)(1) through (4) and (c)(7) to section (c) in the Education Subpart because the concepts related to family style meals are meant to convey the importance of utilizing meal time as an opportunity for children to continue to learn. We also moved some provisions in the existing rule to sections on safety practices in (e.g. food sanitation) and standards of conduct in (c) (e.g. food may not be used as punishment or reward) as those sections are more appropriate, given the reorganization of the rule. We maintained the substantive policies contained within the previous Nutritional Services section at (b) and (c)(5) and (6) with minimal restructuring to improve clarity. We maintained these policies because research demonstrates that one in every five children in America is living in a household without access to adequate food (that rate is likely much higher among the low-income families Head Start serves) and that children who are well nourished are better able to grow and learn. We moved the previous section (c)(3), which requires programs to make accommodations for mothers who wish to breastfeed in a center, to this section, as it is directly related to the nutritional needs of infants and research has clearly established the benefits of breastfeeding. In addition we added the provision for referring to a lactation consultant or counselor if needed. We also included a provision to making safe drinking water available to children during the program day.

18 1302.45 - Child mental health and social and emotional well-beingAddition of “social and emotional well-being” terminology Mental health consultation in all program models: Role of consultants w/teachers, parents, home visitors, and other staff Utilization of consultants Obtaining parental consent Section  Child Mental Health and Social and Emotional Well-being We changed the title of this section to include both child mental health and social and emotional well-being to reduce stigma regarding child mental health and promote understanding of what child mental health encompasses. We moved and revised , which focuses on child mental health services, to be more explicit about program requirements while focusing on supporting positive teacher-child interactions and child emotional well-being. We moved and revised all parent education requirements for mental health into Family Support Services for Health, Nutrition, and Mental Health. To improve how programs use mental health consultants, we specified that mental health consultants must be engaged in supporting teachers for effective classroom management, formulating and implementing strategies for supporting children with challenging behaviors, and facilitating community partnerships in mental health. We also clarified language to describe how often programs should utilize mental health consultation and that programs should make sure mental health consultation becomes integrated throughout the program and at all program levels. We added a provision that programs must obtain parental consent for mental health consultation services at enrollment to reduce the stigma regarding mental health consultation and demonstrate that this service is provided to all children in the program. We reference , Suspension and Expulsion, because mental health consultation is integrated into the steps programs must follow to eliminate expulsion and significantly reduce suspension practices in programs. Research behind some of the changes that were made: Early childhood mental health, or healthy social and emotional well-being, has been clearly linked to children's school readiness outcomes, and research estimates that between 9 percent and 14 percent of young children experience mental health, or social and emotional issues that negatively impact their development. We now require mental health consultation to support teachers because warm and responsive teacher practices and effective classroom management are critical to helping young children maintain or achieve healthy social and emotional well-being and create a classroom environment conducive to learning. Research has demonstrated the benefits of mental health consultation services for child behavior and staff job satisfaction and efficacy in early childhood programs. This research suggests that in order to achieve its mission, the Office of Head Start must ensure that programs are addressing the mental health needs of enrolled children and that programs promote healthy social and emotional well-being through all program services.

19 Linking and Mental health consultants’ role in eliminating expulsions and limiting suspensions – linking back to Prevention focused Collaboration with staff and parents Utilization of community resources Mental health consultants are integral to the steps outlined to limit suspension and eliminate expulsions in hs programs. As a reminder, this reg codifies long standing practice to not expel children from hs programs. Limitations on Suspension and Prohibition on Expulsion A temporary suspension must be used only as a last resort in extraordinary circumstances and before deciding if a temporary suspension is necessary, must collaborate with a mental health consultant, parents, and utilize community resources (behavior coaches, psychologsts, other specialists) to determine if not other option is appropriate. And, if temporarily suspend, important to help the child return to full participation in all program activities as quickly and safely as possible via engaging all the people listed above, developing a written plan to document what is needed for the child, and by providing services that include home visits, and finally by determining whether a referral to a local agency responsible for implementing IDEA is appropriate. Expulsion – cannot expel or unenroll a child from HS because of behavior – must explore all possible steps including engaging a mental health consultant, considering the appropriateness of providing services and supportes under 504, and under IDEA. If, after going through all these steps, and collaborating with everyone, the child’s enrollment continues to be a serious safety threat and it is determined the program is not the most appropriate place for the child, the program must work to directly facilitate a child from the program to amore appropriate placement. Can a child be removed from center based services and put in home based services due to behavior problems? Section (a)(4)(iii) requires that if a program allows the very limited use to temporary suspension due a child’s behavior, the program “…must provide services [during the limited time of that suspension] that include home visits…”  Changing a family’s program option from center based to home base because of a child’s behavior which would not be acceptable.  Placement in the home based option is made at the time of a child’s enrollment with the mutual agreement of the program and the parents.  It is selected as an option because it best meets the family’s need, generally including that a parent is at home with the child and wants the role as the child’s teacher.  The home based option may also be the best option form families who live where no center is available. 

20 1302.46 - Family support services for health, nutrition, and mental healthAddresses health education and support services that programs must deliver to families Improves the clarity and transparency of requirements from the previous rule Highlights the critical importance of parental health literacy Section  Family Support Services for Health, Nutrition, and Mental Health We moved and consolidated all provisions that address health education and support services that must be delivered to families. This will provide greater clarity and transparency regarding these requirements related to family support services for health, nutrition and mental health. We created a standalone section to enumerate program requirements for education and assistance to parents related to health needs. By doing this, we highlighted the critical importance of parental health literacy, defined as a parent's knowledge and understanding about basic health topics as well as their ability to navigate health systems, which has been linked to health and long-term outcomes of young children. In 2009, a systematic review of the literature revealed a link between low parental health literacy and child health outcomes and found evidence that interventions such as providing written materials and counseling can increase parental health knowledge and improve health behaviors. This research, paired with research that documents a strong link between child health and later educational success, suggests that improving parental health literacy has the potential to improve children's school readiness and long-term outcomes, and that Head Start can play a critical role in improving child health and school readiness by directly addressing parental health literacy.   

21 1302.46 - Family support services for health, nutrition, and mental health (cont.)Programs must offer a range of topics for parents including: Home health and safety practices Healthy eating Breastfeeding support Parental and child mental health Help parents access health insurance for themselves and their families In this section, we have two new requirements: The first is a requirement that programs provide opportunities for parents to learn about healthy pregnancy and postpartum care. This new requirement would reflect the importance of prenatal and postpartum care for healthy child development and a renewed focus on ensuring that programs reach as many pregnant women as possible, either directly by providing Early Head Start services to them, or through education when another child is enrolled. The second is a requirement that programs inform parents of opportunities to access health insurance. We included this new requirement because parental health insurance is a significant predictor of child health insurance and that children will get timely health care.

22 Safety Practices Allows flexibility to adjust policies and procedures Health and safety requirements Facilities Equipment Materials Background checks Safety training Safety practices Administrative safety procedures Disaster preparedness plans Section  Safety Practices We moved all provisions related to safety practices from , (e), , , and (b) and (c) of the previous standards. We feel that basic health and safety practices are essential to ensuring high quality care and propose strong safety practices and procedures that will ensure the health and safety of all children. In some instances, we moved away from prescribing extensive detail when such level of regulation is unnecessary to maintain a high standard of safety and too inflexible to allow for growth in standard safety practices. This flexibility allows programs to adjust their policies and procedures according to the most up-to-date information about how to keep children safe. In paragraph (a), we require that programs establish, train staff on, implement, and enforce health and safety practices that ensure children are safe at all times. This places a greater emphasis on ongoing administrative oversight and staff training regulations and should lead to better systems and practice when implemented. To ensure programs are equipped with adequate instruction on how to keep all children safe at all times, we indicated that programs consult Caring for Our Children Basics (https://www.federalregister.gov/​articles/​2014/​12/​18/​ /​caring-for-our-children-basics-comment-request ). Caring for Our Children Basics is a set of recommendations, which are intended to create a common framework to align basic health and safety efforts across all early childhood settings. Caring for Our Children Basics is based on Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, Third Edition, a document produced with the expertise of researchers, physicians, and practitioners working with the American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education, and the Maternal and Child Health Bureau in the Department of Health and Human Services. In paragraph (b), we require health and safety requirements for facilities, equipment and materials, background checks, staff safety training, safety practices staff must follow, hygiene practices, administrative safety procedures, and disaster preparedness plans. The requirements are informed by research and best practice. We require that programs develop and implement a system of management, training, ongoing oversight, correction and continuous improvement adequate to ensure child safety. Additionally, we require that all facilities for center-based programs meet licensing requirements and all family child care programs be licensed to maintain a minimum level of safety. This section references these requirements, which are found in (d)(1) and (d). Finally, in paragraph (c), we require all programs report any safety incidents in accordance with (d)(1)(iii). Additional safety practices related to background checks, and standards of conduct including Head Start-specific supervision requirements and prohibitions on seclusion and restraint, vaccination, and transportation are retained and strengthened in the appropriate Subparts throughout the standards to ensure child safety.

23 Caring for Our Children BasicsProvide guidance on voluntary, basic, minimum health and safety standards for early care and education programs Reduce conflicts and redundancies found in federal program standards that impact early childhood settings Enhance state child care licensing practices and QRIS Improve efficiencies in monitoring systems Create consistent floor across Head Start, child care, and pre-K from which programs would aspire/move to higher quality and upon which parents can rely HSPPS includes: “programs should consult Basics for additional info to develop and implement adequate safety policies and practices described in ” minimum, basic health and safety standards NOT exhaustive Voluntary, baseline health and safety standards for use across child care programs, Head Start, and pre-K. 

24 1302.91 – Staff qualifications related to mental healthMental Health Consultants Must be licensed or certified mental health professionals Have knowledge of and experience in serving young children and their families if available in the community. (8)(ii) – A program must ensure all mental health consultants are licensed or certified mental health professionals. A program must use mental health consultants with knowledge of and experience in serving young children and their families if available in the community.

25 Health Procedures QuestionWhat is the definition for health procedures? Would these be considered health procedures that a licensed professional need to perform:  blood glucose testing (diabetes), epi-pens (allergic reactions), inhaler (asthma) and suppositories (seizures)?

26 1302.91 Staff Qualifications and Competency Requirements(8) Health professional qualification requirements. (i) A program must ensure health procedures are performed only by a licensed or certified health professional. This is the final response that was sent:  Head Start Program Performance Standard (e)(8)(i) states that “a program must ensure health procedures are performed only by a licensed or certified health professional.” While the standards do not include an explicit definition of a health procedure, blood glucose testing for diabetes, administering epi-pens for allergic reactions, inhalers for asthma, or suppositories for seizures; or administering other emergency medications would not be considered a health procedure. What constitutes a health procedure may be dictated by state or local laws or licensing requirements. Programs should consult their Health Services Advisory Committee for guidance when planning to meet the medical needs of enrolled children. Further, programs are required to establish policies and procedures for the administration of medication as described in Standard (b)(7)(iv).

27 – Purpose Resources

28 1302.41 - Collaboration and communication with parents resources

29 1302.41 - Collaboration and communication with parents resourcesThe NCH has partnered with Oregon Health Sciences University to expand their “Well-Child Visit Planner” to include information on well-child visits for children from newborn to age 5. The site helps prepare parents for the questions a pediatrician may ask during the visit, what will happen during the visit, and to identify questions the parent may have for the pediatrician. The toolkit is designed for Head Start staff to sit with families as they walk through the site to prepare for the visits, and the information gained can be used to inform the Head Start family partnership agreement as well. School readiness begins with health!

30 1302.41 - Collaboration and communication with parents resourcesThe NCH has partnered with Oregon Health Sciences University to expand their “Well-Child Visit Planner” to include information on well-child visits for children from newborn to age 5. The site helps prepare parents for the questions a pediatrician may ask during the visit, what will happen during the visit, and to identify questions the parent may have for the pediatrician. The toolkit is designed for Head Start staff to sit with families as they walk through the site to prepare for the visits, and the information gained can be used to inform the Head Start family partnership agreement as well. School readiness begins with health!

31 1302.42 - Child Health Status and Care Resources

32 1302.43 - Oral Health Practices Resources¡Sonrisas Saludables: Un Webinario para Padres, Sobre la Salud Oral! Dental Hygienist Liaison Program

33 1302.44 - Child Nutrition Resources

34 1302.47 - Safety Practices Resources

35 1302.91 – Staff qualifications and competency requirements (for health) resourcesHealth Manager Competencies

36 Mental Health Resources

37 Mental Health Consultation Tool

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39 RESOURCES [BETH] Show resources on ECLKChttps://eclkc.ohs.acf.hhs.gov/policy/presenting

40 HSPPS Resources on ECLKCVideos coming to the Showcase in February General Structure of the HSPPS Infants and Toddlers Dual Language Learners Suspension and Expulsion Family Child Care Option Home Based Option [BETH]

41 HSPPS Resources on ECLKC

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44 HSPPS Copies coming your way soonMultiple copies of the HSPPS and HSELOF are being sent directly to every center, grantee and delegate head offices, and HSSCOs The Preamble to the rule is also being sent to grantee and delegate head offices, and HSSCOs Spanish copies are sent in proportion to number of children whose primary language is Spanish, according to 2016 PIR Look for them at the end of January Addresses are based on HSES data from November Talk a little bit about intent of sending copies to each center – not to sit on a shelf. Talk about why grantee and delegate offices are getting Preambles. HSSCO – Head Start State collaboration office.

45 THANK YOU

46 Thank you for participating today! OHS HSPPS WednesdaysOffice of Head Start Thank you for participating today! OHS HSPPS Wednesdays Head Start Program Performance Standards (HSPPS) Next event: Wednesday, February 15, 2017 2 – 3:30pm EST TOPIC – Early Childhood Systems [WRAP-UP BY ANN] Thank you for joining us today. Please note that our next event for grantees on the HSPPS will be on Wednesday February 15 from 2:00 – 3:30pm ET. We hope you will join us again next month. Thank you.