Title: gratefully acknowledges support for this educational activity from
1gratefully 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
2Partnering to Address Mental Health Concerns in
Early Education and Child Care
- Webinar brought to you by
- American Academy of Pediatrics
- March 23, 2009
3Disclosures
- 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.
4Welcome!
- Marian Earls, MD, FAAP
- Guilford Child Health Inc
- Task Force on Mental Health
- Section on Early Education Child Care
- Section on Developmental Behavioral Pediatrics
5GoToWebinar Attendee Interface
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2. Control Panel
6General 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
7Outline 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 Islands 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
8Overview 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
9US Children in Child Care
- A majority of children less than 6 years old
(60-70) spend time in out-of-home child care. - Young childrens 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
10US 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
11Background
- The most common health concerns for child care
providers are - Infectious diseases (for children lt 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
12Prevalence 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.
13Social 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
14Goals
- Promote healthy physical and emotional
development. - Identify early signs of emotional and/or
behavioral difficulties.
14
15Health ProfessionalsInvolved in Child Care
- Child Care Health Consultants (CCHC)
- Early Childhood Mental Health Consultants (ECMHC)
- Primary Care Clinician (PCC)
15
16Communication and the Medical Home
Primary CareClinician
Child and Family
Early Childhood Mental Health Consultant
Child Care Health Consultant
17Child 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
18Child 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
19Impact 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
20Impact 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 childrens health and Well-being A
report on selected resources. 2006.
http//hcccnsc.edc.org/resources/data/CC_lit_revi
ew_Screen_All.pdf
20
21Early 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 childrens 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
22Early 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
23Early Childhood Mental Health Consultants
- Knowledge of child development, normal growth and
development, and ability to identify atypical
behavior - Understand concepts underlying young childrens
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
Cohen, E., and Kaufmann, R. (2005).
23
24Consult 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
25Impact 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
26Developmental 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
27Primary Care Clinicians
- Primary care clinicians have a critical role to
play in meeting childrens 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
Rosie D. Reforming the Mental Health System in
Massachusetts. Center for Public Representation
Web site. Available at http//www.rosied.org/Defa
ult.aspx?pageId67061. Accessed March 9, 2009
27
28Primary 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 200125-27
28
29Bringing it All Together The Importance of the
Medical Home
- Jack Levine, MD, FAAP
- Section on Early Education Child Care
- Section on Developmental Behavioral Pediatrics
30The Medical Home A Concept rather than a
Building
- Accessible
- Family-centered
- Continuous
- Comprehensive
- Coordinated
- Compassionate
- Culturally Effective
31Successful Early Child Care
Informed, activated family
Integrated, supportive community
Community resources and agencies
Medical Home
Based on Wagner et al.
32Integral 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
33Communication and the Medical Home
Primary CareClinician
Child and Family
Early Childhood Mental Health Consultant
Child Care Health Consultant
34Effective 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!
35Communication With Child Care Providers
- Written communication
- Clear language with no jargon
- Write-out care plan and instructions
- Appreciation for child care provider
- Know childrens behavior in group situations
- Experience with range of childrens behaviors
36Successful Start Rhode Islands Early Childhood
Systems Plan
- Susan Dickstein, PhD
- Bradley/Hasbro Childrens Research Center
- Brown Medical School
37Successful StartRhode Islands Early Childhood
Systems Plan
Improved Outcomes for Children Families
through A More Effective Early Childhood System
38Successful Start VISION To create a
comprehensive and coordinated early childhood
system that supports families and communities in
promoting positive early childhood development so
that all children enter school healthy and
ready to learn.
Successful Start MISSION To ensure that all young
children reach their full potential through a
system of services that promotes healthy
social-emotional development, quality early care
and education, coordinated medical homes, and
effective parent education and family support
services.
39Critical 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
40Critical 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
EARLY CARE EDUCATION
MEDICAL HOMES
PARENT EDUCATION FAMILY SUPPORT
41Mental health consultation to improve child care
contexts
Child Care Support Network Early
Childhood Mental Health Consultation
Funding provided byRI Dept of Human
Services,RI Dept of Health, and the RI Maternal
Child Health Bureau
42- 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
43CCSN 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?
44How 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)
452. CCSN MHC Pilot Yr 1 Who Participated?
46How 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
47What 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
48Summary 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
49Engagement with ECMHC Activities
- On-site Consultation Average rating of
satisfaction with MHC activities4.36 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.)
50Evaluation Questions
- Were there pre-post ECMHC changes in
- classroom functioning?
- teacher practices?
- program supervisory practices?
- rate of expulsion from child care centers?
51Classroom 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)
52Classroom Environment?
- Overall, ECERS/ITERS Total Scores showed
statistically significant improvement from
pre-ECMHC (mean3.67, sd.57) to post-MHC
(mean4.08, sd.62)(scale 1inadequate,
3minimal, 5 good, 7excellent) - Classroom Quality?
- Classroom PIRS Total Scores showed small to
moderate improvement (about 1/2 sd) from
pre-ECMHC (mean3.31, sd.55) to post-ECMHC
(mean3.06, sd.69) - (lower scores are positive)
53Classroom Atmosphere?
- Classroom Atmosphere Total Scores showed no
substantive change from pre-ECMHC (mean3.13,
sd.60) to post-ECMHC (mean3.20, 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)
54Teacher Practices?
- Self-reports by teachers generally showed small
to moderate improvements in several areasa)
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)
55Program 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 (mean3.99, sd.77) to post MHC
(mean4.23, sd.67)
56Rate 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)
57National 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.
58Preventing 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)
59May 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)
60Impact 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!
61How 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 Childrens Developmental and Mental
Health Services within Primary Care and Child
Care Settings
62RI 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
AllChildren Healthy Ready to Learn Early
childhood family services that promote healthy
early childhood physical, cognitive, and
emotional development
- Cross-Sector Goals
- Sector-Specific Goals
- Systems Capacity
- Quality of Services
- Service Integration
- State Community Policy Change
- Program Evaluation
Parent Education Family Support
Early Care Education
Medical Homes
Social-Emotional Development
63LAUNCH SettingProvidence, 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 lt HS education 43 living
in poverty
64Goal 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
65Goal 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
66Goal 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
67Challenges
- 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
68Opportunities
- Training opportunity for early childhood
professionals - State government academic partnership
- Alignment with multiple state initiatives for
improving childrens behavioral and physical
health
69For More Information
- Susan Dickstein, PhD
- 401-793-8731
- Susan_Dickstein_at_brown.edu
- Kristine Campagna, MEd
- 401/222-5927
- Kristine.Campagna_at_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
70Office 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
71Office 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. -
72Early 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.
73Head 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
74Head 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
75Head 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
76Head 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
77Head Start Program Information Report Mental
Health (MH) Services
- Mental health professional
- Consulted with program staff about the childs
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 childs behavioral and/or mental health
60,881 - Provided an individual mental health assessment
69,008 - Facilitated a referral for mental health
services 31,251
78Head 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
79Collaboration To Address Childrens 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
80Head 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
81Head 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
82Head 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.
83For more information
- Barry Marx, MD, FAAP
- Senior Medical Advisor
- Office of Head Start
- Barry.Marx_at_acf.hhs.gov
- Office of Head Start Web site
- http//www.acf.hhs.gov/programs/ohs/about/index.ht
mlmission - Head Start Program Performance Standardshttp//ec
lkc.ohs.acf.hhs.gov/hslc - Committee on Community Health Services
- The Pediatricians Role in Community Pediatrics
- Pediatrics 200511510921094
- http//aappolicy.aappublications.org/cgi/reprint/p
ediatrics115/4/1092.pdf
84Wrapping 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
85Find 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!!!
86Find 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 CCRR
- 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/co
ntact/contact.html
87Question / 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.
88Thank 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