(En inglés) Steve Shuman: Hello, my name is Steve Shuman. I'm a senior training and technical assistant associate in the National Center on Early Childhood Health and Wellness. The Administration for Children and Families created the National Centers to promote excellence through high quality, practical resources and approaches that build early childhood program capacity and promote consistent practices across communities, states, tribes, and territories. Today, we will be discussing Health Services Advisory Committee in Head Start. All Head Start and Early Head Start programs are required to establish and maintain the Health Service Advisory Committee, or HSAC. The HSAC is an advisory group, usually comprised of local health care providers, community representatives, Head Start staff, and families. The HSAC plays a role in community planning by encouraging strong communication, cooperation, and the sharing of information among organizations to improve the delivery of health services to children and families. Collaborative relationships with community organizations promote access to community services for children and families that are responsive to their needs and the assist Early Head Start and Head Start programs to respond to community health needs.

Effective partnerships are the key to the success of this approach. These partnerships enable Head Start to not only respond to the needs of enrolled children and families, but also to create and sustain connections that build healthier communities for everyone. Today, we have a panel of Head Start leaders who have established and maintained exemplary Health Services Advisory Committees with fully engaged members that play meaningful roles in their programs and in their communities. They have also found solutions to many of the challenges that we frequently hear from programs, such as recruiting and retaining membership on the Health Services Advisory Committee. Our panelists represent a diverse cross-section of Head Start and Early Head Start programs, and it's my pleasure to welcome them. I'm going to let each introduce themselves and briefly describe their program. Amada, would you like to start?

Amada Flores: Hi, my name is Amada Flores. I'm the Health Services Specialist for the Community Council of Idaho, Migrant and Seasonal Head Start program. Here in Idaho, our program has 10 Head Start centers across the state of Idaho, and we have funded enrollment of 797 kids. So again, and total Head Start during the summer, and in the winter, we operate six of those 10 for winter programs.

Steve: Thank you, Amada. Tina, would you like to introduce yourself and describe your program?

Tina Handeland: Yes. My name is Tina Handeland and I am the Director of Zaasijiwan Head Start, which is located in northern Wisconsin. We are a tribal program and we have Early Head Start Home-based, Early Head Start Center-based, and Head Start, serving 112 children.

Steve: Thank you, Tina. And which tribe is primarily part of your grantee?

Tina: Lac du Flambeau Band of Lake Superior Chippewa Indians.

Steve: Thank you. Okay. Sandra, would you like to introduce yourself?

Sandra Reece: Sure. My name is Sandra Reece and I'm the Health Specialist with Mid-America Regional Council. As part of Mid-America Regional Council, Mid-America Head Start is part of the Department of Early Learning. We serve 2,000 plus children in Head Start and Early Head Start programs. We are in three county areas, Jackson Clay, and Platte Counties, which consist of urban, rural, and suburban areas. And we have various program options, Center-based home-based, and family child care.
Steve: And Sandra, your program is operating in those counties in Missouri, is that right?

Sandra: Yes, in Clay, Platte, and Jackson County, Missouri.

Steve: Thank you. And then Kansas City is part of that one of those counties? Yes, Kansas City is part of that, it's part of the Jackson County. So Kansas City is part of Jackson County. We partner with four school districts and four delegate agencies to do the direct services.

Steve: And you are joined today by another member of your program and Health Services Advisor Committee. Carol, you want to introduce yourself?

Carol Dietzchold: Hi, I'm Carol Dietzschold and I support Mid-America Head Start as a Health Consultant on child health and development issues.

Steve: Well thank you, Carol. We're glad that you and Sandra are here to talk about Mid-America's Health Services Advisory Committee. Casy, we don't want you to make you last just because your last name begins with a z, but would you introduce yourself?

Casy Ziegler: Sure. My name is Casy Ziegler, and I'm a Program Coordinator and the Health Coordinator for Heartland Early Education in Salina, Kansas. We have a three county service area with a funded enrollment of 301 Head Start and 188 Early Head Start. Our program options include double session, full-day/full-year, childcare partnerships, home-based, and school day/school year with more school day, school [Inaudible].

Steve: Terrific. Casy, thank you and thank you everybody for joining us today and being willing to share your experiences. Many programs, as I said earlier, identify recruiting and retaining committee members as one of their biggest challenges. Sandra and Carol, can you describe how your Health Services Advisory Committee works, and how you recruited people from the greater Kansas City area?

Sandra: Sure. The Mid-America Head Start Health Services Advisory Committee is comprised of grantee and delegated partnership agency staff and community members with expertise and experience in multiple areas of health. The Mid-America Head Start grantee staff works together as a team to facilitate the health services advisory committee. Outside of Mid-America Head Start Staff, Health Services Advisory Committee members include parents, oral health and medical providers, nutritional service providers, mental health service providers, managed care plan representatives, health departments and various other state and local community health and advocacy providers.

Carol: Okay, we started this out as a grassroots effort and the Community Connections Networking Group is 50 plus members and they meet twice a year. But all of those members work interdependently with Head Start and with each other for working with families, within our communities and with the community at large. And this grassroots effort started with Sandra going out with other members of Mid-America Head Start to visit different health care entities within the Kansas City community. And from that grew a grassroots campaign to build, where we went into the community partners to actually take a educational tour with us, called the Portrait of a Healthy Child. And we took that tool with us to visit provider offices, to explain what Head Start was all about, and how the Head Start regulations mirrored the regulations under Medicaid's rules for health care for children. And from that, we developed this three-part educational tool that has a bi-folder. And it has a postcard and a poster that is left within the physician and dental offices. And from those, the parents were able to understand the what, when, and why of the health care requirements, and could actually use that tool and reference that tool inside the provider's offices. Sandra, you want to tell them what [? all ?] went up there?

Sandra: Sure. I would just like to say that's the greatest strategy was good, old-fashioned one to one conversations. As Carol mentioned, we went out to meet with various providers to get them on board with being part of the Health Benefits Advisory Committee. We had committee members to engage other people within the community, to support the Health Services Advisory Committee. So going out, conducting one to one conversations, which is very much important, a part of the whole grassroots organizing principle. And so from there, being able to get individuals as well as providers' offices and other organizations on board, to support the work of Head Start.

Steve: Sandra and Carol, thank you. It sounds like you're using really powerful community organizing skills. I love Sandra, that you said good old fashioned one to one conversations. And Carol, you underscored the intentionality, where you had the materials that you brought to show what Head Start expects for children who are healthy, and left materials for follow-up as well. So those are all really intentional strategies that you incorporated into your efforts. On a regular basis, Sandra, how many members of your Health Services Advisory do you have?

Sandra: We have 40 plus members that meet with us twice a year, and then we have individual members, part of the Health Services Advisory Committee, that meets with us throughout the year. They maybe provide training, they may provide access to services. We have one that is currently working with us to host an oral health roundtable, where we are bringing in a dentist to support us with oral health needs. And the whole goal is that these groups of dentists that are currently working Head Start will be able to reach other dentists that are not working in Head Start, and so how they can support us with that effort. We know that people come together based on friendships, based on relationships, and based on the nature of the work.

Steve: I love it. And it sounds like you have these two formal meetings, but people are engaged in one way or another throughout the year, so that's --

Sandra: Right. Yes, Head Start Health Services Advisory Committee is fluid, which means that you may have individuals who can meet with you at all times, and then you may have individuals that cannot. So we have to find ways to get those individuals who are not able to meet consistently continue to be engaged.

Steve: Okay. Well thank you. I think we have a picture of Mid-America Regional Council's Health Services Advisory Committee. Thanks. We're going to be coming back to both of you. Amada, your program stretches across a large rural area, and meets the needs of migrant and seasonal families. You mentioned to me that you are required to be quite creative across the 10 centers that you operate at different times of the year. And you have some really intentional ways that you go about recruiting families, in particular. You want to talk about that?

Amada: Sure. You know, the Community Council of Idaho has been operating for 45 plus years, and I've been working here for the last 18 seasons. So I've seen different ways of operate Health Services Advisory Committee, and I think that we've gotten to a place where it really works for us, because we are so rural. So what we did is we created a Health Services Advisory structure, and that demonstrated how HSAC is interconnected. We call it HSAC instead of HSAC. It's okay. Of how we call our committees, but just so that you know. And we wanted to represent how our center HSACs and our state HSACs are interconnected, and I'll explain just a little bit.
And we needed to have that structure so that we can have policy council approval of how we wanted to implement our HSAC. So first of all in our structure, we have center HSAC meetings. And so what that means is that 10, each 10 of our facilities across the state of Idaho, put together their own Health Services Advisory Committee and they meet two times a season. The case manager and the education coordinator at each of those facilities are the facilitators of the committees.

So they help guide the parents, and they help make sure that they understand the process and what's required as far as documentation. And then there is the HSAC parent representative and an alternate that is part of that. And there's an election process that I'll explain in just a minute. And then we go in our structure to our state HSAC. The state HSAC is, they meet two times a year, and we have representations of each of our centers, HSAC representatives and their alternates, come to that. And we also invite our community members. We try to have one or two community members participate in that state HSAC. And of course our center's staff facilitators, case managers, and education coordinators are part of that. So then I'm going to go back to what we do at our center HSACs. We created a HSAC orientation brochure. We want to make sure that our staff at our facilities understand the purpose and how to explain this to our parents. So that's why we put together this brochure. It's in English and in Spanish so that we can provide an orientation at our election night. So each center goes through center election night, and at that election night, they receive orientation about the program, about the different committees we have, and then so our case managers and education coordinators go up and they provide the HSAC orientation before elections are made. And then they elect a parent representative, a HSAC parent representative, and an alternate for their center.

The case manager and the HSAC representative -- sometimes the education coordinator as well -- they schedule a planning meeting and they decide what the next topics will be. You know, what is going on locally health-wise. What is it that they want to talk about, what's going on at a local, state, and national level? They decide the topics that are going to be included. The case manager will bring a report that we call the Strengths and Needs Assessment. These questions are asked during our enrollment process, and so we use that to show the parents -- this is what the parents at our Head Start are saying is important to us -- or important to them. And so they see how we can incorporate their interests into our discussions at HSAC. So we tie that in so that we can grasp an interest from the parents that are invited to the Health Services Advisory Committee.

Steve: Amada, I really appreciate you describing so much of this integration of the Health Services Advisory Committee into the family engagement process, and really create this powerful mechanism for including families right from the very beginning, both their strengths and interests, as well as their representation. I just want to clarify, when you describe your they state HSAC, you're describing something for your entire agency, not for the state of Idaho, is that correct?

Amada: Yes, it's for our whole agency. So the local HSAC parent representatives and our staff from each of the facilities come together for a state HSAC meeting, and it's very unique how we do this. And you know, dealing with technology is a difficult thing, but we video conference. And so we have -- the main
HSAC is held here at our central office in Caldwell, Idaho, and we call into central Idaho, to east Idaho. And the parents and the staff get together at those locations and we video conference. We stream them in and we have telephones all connected and going so we can hear each other. And, you know, the meeting that -- the parent HSACs, the parent representatives are actually the ones that take the lead. We're, like you said, our staff are just the facilitators, but we ask our parents to take the lead so that we can help them build those skills on how to present, how to build that inner authority. And it just, it really builds a strong HSAC for our agency at a state level when parents take the lead at their local centers, because they're representing the rest of the families at their center at the state HSAC.

Steve: Amada one last question. Can you talk a little bit about the health professionals that are also part of these groups, besides the families?

Amada: Yes, so we have just a variety of different community partners. We have pediatricians, we have dentists that come to our local and state HSAC meetings, dietitians, phlebotomists, we have nutritionists come in, we have the local health department. They're the strongest representation at our HSACs. At our center HSACs and also for our state HSACs. They are very involved. And as you know, the health departments have different types of services. So when we have different discussions, we ask our community partners that are part of our HSAC, and when we need to, we also call and ask other community representatives to join us. And when we do that, they tend to want to continue coming, because they like the conversation and they like being involved in a community effort. So whenever we have a topic that we need to talk about, we ask the community partner that is related to that topic to present some educational information. And then we go into discussion, and then if there's further clarification, then they step in and provide that clarification that is needed to ultimately make decisions for the program, because this Health Services Advisory Committee has been a big part of policy update, improvements, service coordination, and so it really takes a strong HSAC to be able to do that. And parents are very engaged in that process because they provide their input, what's going to work for them, what doesn't work for them. And then the community partners are there listening to what works and what doesn't work. And then we figure out the best way to provide services, or to update policies and procedures that makes sense.

Steve: Thanks, Amada. Tina, unlike what is Sandra and Carol described for the large area that they cover, or the large geographic area that Amada covers in her program, you work on a much different scale, a much smaller American Indian community. Can you talk about how you recruit people on and off the reservation onto your committee?

Tina: Well most of the people that we recruit for the agencies are from the reservation. And part of that is because most of our resources are here. And so when it comes to children's health, the most important aspect of recruitment and retention is finding those individuals from agencies who share that same passion in providing services to infants and toddlers. That seems to be the key element for us. And making sure that those individuals are, or -- no, I shouldn't say making sure. What these individuals tend to be more committed to serving on boards with those specific things in mind. And it's also crucial, I think, for us, is to set our dates early in the year and immediately secure a site. Preferably the same site so that it develops some consistency. And that pretty much covers what happens on a small scale. And you meet with some frequency, as I remember from our earlier conversation.

Steve: You want to talk about how often you meet?

Tina: Yes, typically in the summer time around July, we have one meeting and we get everybody together to find out what dates work the best, right before, especially, like our larger activity, like the child development days. And we will set dates that start in October, and then we continuously meet up until the child development days. And then we also have a debriefing meeting that we do after the child development days are done. And you have some very specific expertise on your committee that meets many of the needs that your families have. If you want to talk about some of the experts that you have on your group? Some of them come from community health. We have nutrition or dietitian, we have some agencies that come from what's called Great Lakes Intertribal Council, and there are many programs that specific agency services, in terms of working with early childhood. There are also different representatives from our domestic abuse shelter. We have an optometrist, dental staff, and quite a few nurses and other people that provide home visiting services to the families.
Steve: One of the things that I was really struck by, Tina, when you and I spoke earlier is how familiar your committee members are with the families you serve, and that would include being very comfortable serving a tribal community. Have you specifically made that happen on your committee, or do people come with that expertise or interest?

Tina: Well part of that is that making sure that we're providing services for the children in those areas. And what the Health Service Advisory Committee can do is recommend a certain individual to see if they would be a good fit. And otherwise, we -- being so small, we can do that one on one, or the face to face contact, and that is also very helpful.

Steve: Thank you, thank you, Tina. I really appreciate you describing all that. Casy, we're going to give you a chance to talk about how you've gone about recruiting and retaining members in your community in Kansas. Casy: Well I think the most important idea that I try to keep in front of me is relevant. And I think that if the Health Services Advisory can be relevant to me, be helpful to me, it can also be helpful to other early childhood and health agencies in our community. So I think I always keep that in the front of my mind. And I think part of it is the size of our community. Salina is a town of about 50,000 and there's a group of us that have been in early childhood for, I don't want to say it, but for decades, and we cross paths all the time on all different kinds of committees. And it's those same people that I've recruited to be on Health Services Advisory and they've got by in. They know what I do, they know what I can do for them, I know what they can do for me. It's a two-way street.

Steve: I love that two-way street metaphor, because I'm always about and trying to create successful community engagement is a win-win. That it's not just for Head Start, it's also for all of your participants, that they're getting something out of it. Easy: Right. As much as we want to think we can, we can't do everything for everybody. And so we do need all those community agencies to help us. And we all know that health is vital to a child's learning, and if children are healthy and parents are healthy, that allows them to make school a priority for their children, because they have less things to worry about.

Steve: Thank you Casy. You had some interesting activities come out of all of this community engagement. You want to talk about some of your successes that you've had there in Kansas? Casy: Sure. I would have to say, I would echo what one of the other programs said, that the health department is a big part of our HSAC, as we call it. We've -- everything from when Zika virus came out, doing updates on that, to now we have the WIC program come to our main enrollment event that we have in the summer. They come and sign up people at WIC at the same time we're doing that. And they do hemoglobins for us and that's been a great partnership. We also have a great partner in our Safety Net clinic, especially their dental clinic. Dr. Abbick he is a true -- what's the word I'm looking for -- Sorry. Advocate for -- advocate for children. And we have an under-served dental population, I think for the whole state of Kansas, but definitely in Salina. And we have a real trouble with dentists wanting to see children under the ages of three. And he had recruited a dental surgeon who had come from Overland Park, which is the Kansas City area about three hours away, who would come to our community once a month and do procedures at the Hospital for children who could not have things done in just a dental office. And that was a great partnership. Unfortunately that pediatric dentist retired. But I know that Dr. Abbick is looking for another one.

The other thing Dr. Abbick brought was a few years ago, there was a big to do in our community about fluoridation in water and whether it should be there and what things it could be causing. And there was really quite a community uprising and people wanting to take the fluoride out of our water. And Dr. Abbick brought that to our group. He knew that he had people there that could understand what he was saying, and people that could also put it out to lots of other families about the importance of fluoridation, fluoride in the water. And that did not end up -- we still have fluoride in our water in Salina Kansas, and I really think our group had a big part to do with that. We also, in Kansas, have what's called Kansas Mission of Mercy, and it is a yearly event that happens, I think it rotates between about four cities across the state, and they do dental services for families. And we had it in our community two years ago, and Dr. Abbick again, was the -- he's the one that put it all together. And he made sure that there were slots available by appointment for children to be able to be seen at KMOM, which is Kansas Mission of Mercy. So that was a huge benefit to not only our community, but for the hundred mile radius, probably, around us.

Steve: Well thank you. Sounds quite involved, both inside the Head Start program and in the larger community that you are part of. Tina, I wonder if you can talk about some of the activities that your group is involved with on a regular basis? I know you talked about having them involved in your annual Child-find effort, and then some other more regular activities during the year.

Tina: Yes. Throughout the year, the agencies provide a lot of parent education trainings on health topics. And there are quite a few topics that they come in to help with.

Also we have the dental walk overs that we do, and that's in late spring. The children walk with their classes over to the dental clinic, and that way they're able to get their screenings done. And we also have monthly onsite dental education and nutritional education that are provided for us. And that's also very -- it helps to identify any issues early with the children, if maybe they are showing signs of cavities and working with a health coordinator. And also, we have, onsite, are the mental health observations and consultations. And again, the neat thing is that all the resources are under the auspices of the tribe, and that makes it a little bit easier to gather those MOUs and make these things possible.

Steve: Terrific. Good to hear. Amada, some of the activities that your both local and state groups have engaged in have really been quite impressive. So you want to talk about some of the things that your groups have done?

Amada: Yes. So I think that our HSAC has built really strong relationships with community partners. And when we put together events to address some of the things that come up as a need, or when we need them to provide input at a professional level, they typically step up. And that is so true to one of the projects that our program is currently ending, unfortunately. This program is ending, and I'll tell you a little bit more about that. A couple of years ago, we applied for a grant through Cambia Foundation and we were approved for $200,000. And the reason that we were approved was because we were able to identify a need that was not typical and that was very unique to the population that we serve. And it came about through a HSAC discussion of our rates of childhood obesity within our program. And at the state level, the childhood obesity rate was a little bit over 11% within preschool age. And within just our program, it was up 34%, so almost three times the state percentage. So we wanted to take action as a program, and the HSAC agreed that we need to move forward with some grant writing, to see if we could put together a health literacy program. So we partnered with the University of Idahp and they helped us right the grant. They helped us with additional research in the state of Idaho, and we found that the farm working community, that there was very little data for the farm working population as it related to childhood obesity.

So they put together a grant around meeting that need. And so Cambia did award us $200,000 for a two year project. And it was around building the foundation to build a health literacy program, to prevent childhood obesity in the farm working population. So we -- I mean, it was great news when we first got that grant award, and it put us in action for many things. We had several community partners on our HSAC already, but we needed to reach out to even more. We had healthcare providers, nurses, nutritionists, diabetes coordinators, phlebotomists joined our HSAC team, and several other community partners across the state stepped up to help us coordinate the services, because this was a statewide project. So how we did that is that we established community partner agreements with our HSAC members and new HSAC members, saying that part of our agreement was for them to be part of the Health Services Advisory Committee and our program, at the local level and at the state level.

And so I believe that they stayed with us during these last two years because everyone was actively involved, and they felt vested in our project. And I think that's the best way of how we were able to retain our community partners throughout this project. And so I feel very successful. I feel the program is very successful. This winter will be our last season that we're implementing the Cambia grant, and the University of Idaho is going to be looking at our data and doing the analysis of that so that we can report to our funding source. And so I hope to be able to share that with you guys. I know that I've seen preliminary data, but I am very anxious to see what the results of all our hard work will be.

Steve: It's very exciting. I think this idea of keeping people involved in a meaningful way is such an important part of retention. And the fact that they were also, because of their energy and their interests, were able to identify a significant amount of new dollars for a project, time limited though it is. But a significant amount of dollars to really get information that will help children and families as you move forward. So that's very exciting. Thank you. Sandra and Carol, I wonder if you can talk a little bit about some of the specific activities that your group engages in at Mid-America, both inside the program and outside in your community.

Carol: Okay, well this is Carol, and I can tell you about how the HSAC works within our Head Start itself. Our providers work hand-in-hand with all of our sites, whether it be a partnership or a delegate site. And they help us by promoting and holding health clinics, both medical and dental. Our managed care programs help with that also. They've set up specific EPSDT or physical exam days in conjunction with the health department. Our local education agencies, such as Parents as Teachers and Saving Sight from the Missouri Lions, do screening for us, developmentally and sensory screenings. We have a tremendous working relationship with the Kansas City health department and the red coalition too, because we have many of our children living in high risk areas, who through the age of five going into kindergarten, do annual lead screening for our children. And they come into all of our sites and do those. Also one of the
things that's been very integral within the HSAC members is to help us write a grant, in which we were able to purchase hearing and vision equipment, so that this equipment is sitting inside Head Start. So it can be taken either to each of the delegates or partnerships or they have their own that they can use. And secondary to that was, within that grant, we were able to work on having an interpreter for the different languages, and work with an interpreting service within the Kansas City area for our ESL families. And from that, we have a member of our committee who is now our medical director, and another member who is our oral health director. And so those people are in place to help us continue to navigate within the community. And we also have our safety net clinics, our [Inaudible] qualified health clinics who provide health and dental services to our uninsured and underinsured children. And in many cases, to members of their own family. So that's how we're working kind of one on one within the clinics, and Sandra will tell you how we're working within the state systems.

Sandra: Well I would say that the Health Services Advisory Committee members have been very instrumental in helping us to access state and local data systems through our HIE health information exchange consent form, which means where parents give consent to the Head Start program to query these registries, to obtain documents of any kind of physical screenings that have occurred at a provider's office, which reduces the duplication of services. So the Health Services Advisory committee was instrumental in helping us to just understand that that system exists within our community at the local and state level. Some of those systems consist of public health profiles, where we can obtain information about a child's immunizations, their lead screening, their health insurance. Show me back also provides opportunities for us to clear their system, to understand or find out their immunizations. And then email may helps us to gather other additional information. We also have partnership with a local information exchange, so we can look and find out if the child has had a physical, the results of screenings, heights, weights. If they have any kind of chronic conditions, that information is noted. So it helps us to be able to go out and request documentation of these physical exams. The Health Services Advisory has also helped us with establishing health processes, to receive health documentation of completed exams and screenings in a timely manner. Anybody knows that that can be difficult for many Head Start programs, with the receipt of complete exams, and sometimes you just have to ask for information over and over. Well through these processes, we are able to eliminate some of that, which has helped us to increase the completion of health requirements, helped us to manage children with chronic health conditions, provide monitoring to decrease, as I said earlier, duplication of services.

Steve: Sandra and Carol, thank you. All of you have described situations where the Health Services Advisory Committee is not something that is just done because it's in the performance standards, but it's a really important part of your program and your community, so that's really impressive. In all my conversations with all of you, I've been so impressed with the amount of work that you've put into it, but also the amount that your program gets out of it, so thank you for that. I wonder -- we hear from a lot of -- at the National Center, we hear from a lot of new health managers that really struggle with getting their Health Services Advisory Committees off the ground and successful. I wonder if you could each, maybe, have a word of advice to new people that are entering the field or experienced people that haven't felt the same levels of success that you've had. Casy, do you have some words of wisdom that you'd like to share? Casy: Just adding on to what you just said is if you just think of Health Services Advisory as another tool in your toolbox, that it should be helpful for you. And if it's not, then you could be doing it better.

Steve: Thanks, Casy. How about you, Tina, any words of wisdom?

Tina: Well I think most importantly, first of all establish collaboration. And again, find people who share that same passion. And then once that is initiated, continue to maintain that consistency.

Steve: Good advice. Amada, how about you? Do you have some advice for our listeners?

Amada: Yeah. So we know that it takes time to grow your HSAC and you just have to be a little bit patient. But I think that your center staff and parents are great resources. They will help you identify which community partners work well with Head Start and who would be interested in working together. And then take time to meet with your community partners. You might be surprised that we are all working and looking for ways to work together and to leverage our resources.

Steve: Beautifully said. Sandra and Carol, do you have some advice for your colleagues across the country?

Carol: Well this is Carol. And I'm a very visually context person, so I look at this like a climbing rose on a trellis. And what Sandra and I talked about is, you have to start with that root, that grassroots campaign. And as that root is established, then you're going to grow and it's going to grow season and season, and it's going to spread. And if you look at the trellis as the community, then the rose, the climbing rose is going to incorporate that community. And as it becomes stronger, it becomes a greater influence on that community, just like the rose becomes a greater influence within your garden. And so that's how I see it and that's how I feel like this committee works within all of the Head Starts across the country.

Steve: It sounds like you're more than just a visual person, you're also a gardener, Carol.

Carol: That might be also.

Steve: Sandra, how about some advice from you?

Sandra: I would say the greatest words of advice I would have is to build collaborations internally within your own organization as well as those relationships with community members, because that is where you're going to find the greatest strengths. And to find a champion that can support your work, and who will be able to speak on your behalf, even when you are not there.

Steve: Well said. Thank you all. Thank you Sandra, Carol, Amada, Tina, and Casey. I don't think I can say anything more or better than what you've said already. The relevance of the work that each of your committee members brings and the intentionality that each of you and your colleagues in your program engage in to make sure that the right people are there, that they're supported fully, that the parents are prepared to take on leadership roles, and that their needs and voices are heard, and that it benefits not only your program, but the community. On behalf of the National Center and Early Childhood Health and Wellness, let me thank you again for contributing to this recording, and extend our heartfelt gratitude for all you do for children and families.

We are going to make sure that those who are listening and watching this recording have an ability to contact you by reaching us first at the National Center on Early Childhood Health and Wellness at our email address, health@ecetta.info, in case they have some follow up questions.

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(En inglés)

Steve Shuman: Do you think you're getting the most out of your Health Services Advisory Committee, or HSAC? Have you ever wondered about innovative ways to engage your members? This health chat offers strategies to help you maximize the effectiveness of your HSAC. You can use the information in this health chat in one of two ways. Individuals who are new to Head Start or your role in running an HSAC will find information on slides 5 to 15 to help you learn more about HSACs and how your HSAC can support the health services your program provides.

Those who are already familiar with HSACs and may have challenges recruiting or engaging members will find strategies on slides 16 through 58 that you can use to recruit, engage, and retain HSAC members when there are geographic, financial, or time constraints that make it difficult for them to meet face-to-face. All the supplemental materials for this presentation can be found on the Early Childhood Learning and Knowledge Center, or ECLKC. Look for the "Materials" link underneath this recording.

My name is Steve Shuman. I have been a Head Start director, and I have been providing technical assistance and training on early childhood public health topics since 1987. My colleague, Nancy ToppingTailby, and I are from the Head Start National Center on Health. Nancy is also a former Head Start and Early Head Start program director and a behavioral health clinician who has worked with Head Start staff and families for more than 20 years at a local, state, and national level.

Nancy Topping-Tailby: Thanks, Steve. This health chat focuses on some concrete ways to enhance your work with your Health Services Advisory Committee (HSAC) based on our own experiences as well as those of many other Head Start health leaders responsible for managing HSACs. Participants who view this health chat will increase your understanding of how to use HSACs to strengthen health services for enrolled children and families, identify the benefits of virtual meeting technology, apply new strategies to recruit, engage, and retain HSAC members, and strengthen collaborations with and improve contributions from HSAC members. This health chat features information from the revised version of Weaving Connections and from lessons learned from programs that effectively use technology.

The Head Start Program Performance Standards require every Head Start and Early Head Start agency and delegate to establish and maintain a Health Services Advisory Committee. The HSAC has broad advisory functions that are determined by each program to implement health services that meet the needs of enrolled children and families. HSACs can make recommendations but don't have decision making authority.

Committee members include families, staff, especially health staff, managers, and program directors and community representatives, health professionals such as dentists, pediatricians, social workers, and mental health professionals. The offer their services on a volunteer basis and are not compensated for their participation. The HSAC's membership should represent the breadth and depth of your program's health services. The members of the HSAC best determine their own meeting schedules.

The Health Services Advisory Committee plays an important role in weaving together multiple community connections. HSACs can assist local programs in a variety of activities including developing and reviewing health-related plans, policies, and procedures, training staff and families on health topics, accessing community health resources, and connecting families to medical and dental homes. The goal of Head Start health services is to promote children's healthy growth and development. This means that staff and families work together to prevent health problems, identify children's health concerns, and obtain treatment for an illness or health condition once it has been identified.

Effective partnerships are the key to success. These partnerships enable Head Start to support the health and wellness of Head Start families, improve coordination and communication among families, providers, and program staff, and respond to changes in the health care delivery system. Your Health Services Advisory Committee supports Head Start health services by embracing and supporting your program's goals, objectives, and expected outcomes. For example, it can help your program meet your program and school readiness goals. HSACs can also help to develop policies in response to changes in health status in the center and the community. Each program's Health Services Advisory Committee may offer guidance and support to build and maintain high-quality health services.

The HSAC plays an important role in ensuring that your program provides comprehensive, integrated, and effective health services to enrolled children and their families. When HSAC members are aware of your program's needs, they can advise you on how to strengthen the health services you deliver and mobilize community resources. HSACs can offer great problem-solving strategies on a range of issues.

For example, from choosing the right surfacing for your new playground to respond to a spike in illness or an outbreak of lice in a particular center. Now, Steve will tell you about how your HSAC and strengthening community collaborations that promote health and well-being.

Steve Shuman: In 2012, the Advisory Committee on Head Start Research and Evaluation outlined several recommendations to further promote the health and well-being of the children and families who attend Head Start and Early Head Start programs. The recommendations specifically address increasing collaboration among all Head Start stakeholders including health professionals and health professional organizations within the community to better leverage local resources and to improve the consistency of messages and services for local Head Start programs. To do this, you have to establish ongoing collaborative relationships with community organizations that will promote access to and improve the delivery of community services for children and families.

In addition, and to ensure that your program is responsive to community needs, you will need to facilitate strong communication, cooperation, and information-sharing efforts among program staff, families, and all of your community partners. Your Health Services Advisory committee can engage community members with varied expertise. This may include dental hygienists, community health workers, physicians, office practice managers, nutritionists, social workers, and nurses. Clinicians and
other health professionals provide credible expert health information and offer evidence-based perspectives.

They can assist with community assessments, program planning and policies, recruit other health providers to serve Head Start children, and refer families to Head Start and Early Head Start programs.

Families play a central role in the Health Services Advisory Committee. They bring their perspective about the availability and quality of local services as well as the gaps and barriers to care for low-income families. This perspective creates the context for a family-centered focus for conversations with other HSAC members. The Health Services Advisory Committee provides a unique opportunity to engage decision-makers, health professionals, and families in meaningful discussions that address substantive issues.

Many members of your HSAC can contribute data, adding to your own data sources. Each member will also bring his or her perspective to help you analyze your aggregated data. This analysis can drive decisions, identify areas needing to be addressed, and even inform your committee's recruitment efforts.

For instance, if you discover high rates of asthma among the children in your program, you may want to recruit experts in environmental health, housing, asthma education, and medication management on your committee so you have the right HSAC members to advise you on critical health issues that impact the well-being of program participants. Your Head Start program and your community benefit when your Health Services Advisory Committee members represent both the diversity of the community and the diversity of its health and safety needs.

First responders, such as EMTs and firefighters, can bring a strong knowledge of emergency preparedness while pediatricians and dentists can speak about physical and oral health. Nutritionists and dieticians can address issues of healthy weight. And doulas and lactation consultants can identify important concerns for expectant families and families with infants. But first you need to make sure that you can define the criteria for membership so that you encourage participation from community partners that you want to recruit and retain. If you have trouble getting members to join, think creatively not only about how you recruit them but also about challenges to their participation.

The timing and location of meetings can be very important considerations. Lunchtime is quite popular among many programs. Early morning meetings may work best for others. Some programs hold meetings following pediatric grand rounds at their local hospital. Attendance is excellent because they found times when members could take a moment from their duties to sit down and reflect on how to better serve children and families. There are very real challenges to participating in meetings. Family members may be working or attending school. Taking time off to go to a daytime meeting is often impossible. Working professionals also face challenges that make it difficult to take time away from work when everyone is busy and accountable to their own organization.

In fact, a 2012 survey by the Physicians Foundation found that fewer than one-quarter of respondents had time to assume additional duties. Benjamin Franklin was famously quoted as saying, "Time is money." Today, there is a cost to doing business including attending meetings. There is an associated cost when providers are not engaged in direct care. Geographic distance is another significant challenge for many health professionals who would like to attend a Health Services Advisory Committee on site.

Distance can be a barrier in an urban setting. It is even more of a challenge in rural and frontier communities, tribal lands, or geographically diverse communities when grantees are spread over ten or more counties. Some specialists and experts may be even further away. In one study, the average distance families had to travel to see a developmental pediatrician was 44 miles. Other specialists reported an average of 75 miles.

Nancy Topping-Tailby: Fortunately, there are solutions to these challenges. Programs can use
technology to engage local health experts with time and distance challenges. These members can
contribute by using virtual meeting tools. Members can use something as simple as a telephone to attend a meeting. The Health Services Advisory Committee can also create an online community to share documents and post information in between meetings. Meeting this way allows an HSAC to draw upon a wider group of members including working parents and professionals with relevant knowledge or skills who may work some distance from the program or whose schedules do not permit them to attend meetings in person. Instead of spending several hours traveling, attendees can take an hour or so to attend the meeting from the convenience of their home or office.

In addition, those unable to attend the meeting can review an archived recording and discuss issues and trends after the live meeting. Members can also build productive working relationships by connecting with each other in between regular meetings. The National Center on Health has created a directory of virtual meeting tools that list a wide range of free or low-cost collaboration tools using technology. It can be found on the Early Childhood Learning and Knowledge Center. To access the directory, look for the "Materials" link underneath this recording.

You can tailor the way you use these tools to meet the needs and capabilities of the members of your network. The directory briefly describes several types of tools and their uses. It offers a quick view with examples of each type. Since many of these tools are designed for different purposes, you'll want to select the tool or tools that best suit your needs. An instant messenger or IM service allows people to have an online conversation known as a group chat by typing to each other and sending messages that you can view instantly. Group email lists or LISTSERVs link many people together with one email address.

File-sharing allows multiple people in different locations to work on projects collaboratively at the same time or at their convenience.

A group website allows members to see calendars, post questions and events, and view documents.

Social media sites allow members to follow new information almost instantly.

Steve Shuman: So what does this technology look like in action? The East Coast Migrant Head Start Project has the unique challenge of working across 12 states. Agency-wide meetings regularly take advantage of virtual technologies.

In the following clip, you will hear from staff participating in a virtual obesity task force meeting. Their agency's Health Services Advisory Committee recommended this task force to promote healthy active living.

[Video begins]

Deborah Booth: Because we are a multi-state grantee with both delegate agencies and direct services, communication has always been something that we pay a lot of attention to and how we do that. We particularly like being able to do this when you're really trying to work on a project together because you can get that back and forth with each other using the video conference than you can over the phone.

Megan Squires: It's really great to bring all the perspectives in from the different regions, and that's what I appreciate it about it most, because what's going on in Alabama is very different from what's going on in Florida. It's good for us to hear those perspectives and to be reminded of them. We're all on the same page about where our kids are.

Female video conference participant: But I don't know how that impacts the other -- because --
Deborah Booth: We have found it very helpful and useful, and it's certainly not just the fiscal part of, you know, decreasing travel costs, but also, wear and tear on our staff because they still do a fair amount of travel, as you would with the multi-state program.

Female video conference participant: Embedding that whole, that line into our procedures.

Megan Squires: Everyone feels more on-point. Sometimes, when we're all together in a group meeting in person, the conversation might stray, so it's kind of neat to pay attention to the different dynamics with using a video conference. Moving forward, this is something that we want to think we want to target all kids, if there's a plan of action that we want to think about. What can we do, you know, to get this more part of our culture?

Deborah Booth: Being able to have meetings for like my department and I get to see them at the same time and we're not doing conference calls and they didn't have to travel here, it has tremendously helped what we do. Probably see what's happening at home, and maybe we can work at home. There are so many games out there and activities out there that could help with the learning as well.

Megan Squires: It doesn't impact the quality of the services that we're providing. If anything, it's just -- it's a great resource. It's an enhancement. I think for me it's awesome because I really like to see the person over there, but also I've had my mentors and managers come on and do how Sophia says... Like any meeting where the more perspectives and wisdom and knowledge that you bring to, in this case, virtual table, the more likely you are to come away with plans and strategies that will be more meaningful and more effective. So, you know, it does just help us to facilitate better planning, so it's a great tool.

Megan Squires: People feel like they have to be more present physically and verbally. They feel more responsibility to be part of the meeting and have more quality comments to say, I think, kind of like they would in an in-person meeting. We can bring more stakeholders into the meeting and they can be hundreds of miles away.

Steve Shuman: The East Coast Migrant Head Start Project researched technology options to plan for a major expenditure and choose the right technology package for their program. And while it was a considerable outlay, it has substantially reduced travel costs. But remember that the directory of virtual meeting tools provides a number of low-cost technology options, too. The National Center on Health wants to thank everyone at the East Coast Migrant Head Start Project for allowing us to observe their meeting for sharing their time and expertise and, most of all, for sharing the many lessons learned for how to run successful virtual meetings.

Nancy Topping-Tailby: It's not easy to run a good meeting. It can be even harder to run an effective virtual meeting. Running a successful virtual meeting requires careful planning, skilled facilitation, and technical support. Before the meeting, set an agenda in advance. If it's a lengthy meeting with many people attending, your agenda should also list the timing and objectives for each agenda item. By making the purpose clear, everyone will feel that their time is well used. Your advanced preparation shows respect to the participants and to the organization.

Any handouts, documents that will be reviewed by the group, and available slides and visuals should be attached along with the agenda as a backup in case the technology doesn't work. Family members may need materials translated into the languages they are most comfortable reading. If participants are
going to review a large document, such as policy and procedure manuals, give them plenty of time to read and comment. Include the phone number and/or the URL on the agenda and in any messages that you send. Appoint a backup facilitator and review the agenda together. Make sure this individual knows the host code to your conference call or virtual meeting software so they can run the meeting, if you are absent or unable to connect.

Practice with the technology. Make sure you can navigate confidently and use the features of the
technology you choose for your meeting. Prepare a contingency plan because technology can
sometimes fail at a key moment. Whenever possible, have technical support available during the
meeting to help you or any participants having difficulties. Some organizations employ technology staff.

In addition, some virtual meeting companies that provide virtual meeting software also offer TA.

Steve Shuman: At the beginning of the meeting, be there 15 to 30 minutes early in the room, on the phone, and online, so you can boot up and test. There's nothing worse than watching and listening as somebody fumbles with the technology. Greet each arrival as they beep in by asking: "Hi, who just joined us?" Engage participants in small talk just as you would if you were face-to-face in a room prior to beginning the meeting. When everyone is assembled, introduce the attendees and their roles. Make sure everyone knows why they are at this meeting. Create a feeling of a team or community of purpose right from the very beginning. Keeping everyone feeling involved and welcome decreases the sense of isolation and distance among participants.

Nancy Topping-Tailby: Begin the meeting on time and don't start over for late-comers. It's unfair to the people who arrived on time and it slows down the meeting. Consider adding a note to the agenda that late-comers will be acknowledged by the facilitator perhaps at the 15-minute mark. Stay on task and do not multitask. It is easy to lose focus. You already have a big job. Watch the clock, take attendance, record notes, and make sure the discussion is moving. Keep the pace lively. You don't have visual cues the way you might with an in-person meeting, so be sensitive to pacing. If you are sharing your desktop as a presenter, avoid excessive scrolling, sudden rapid cursor movements, or jumping too quickly between pages. It can be disorienting for viewers.

Make sure everyone has an opportunity to share. Keep track of who's not participating and call on them periodically. You can ask how might this apply to your area, or what factors would contribute to making this work. Try to get all participants to engage with each other, not just with you. Remember that not everyone is in the same room. If there are some attendees on the phone or online, the remote
attendees may feel left out.

Speak clearly into the microphone. Limit private jokes, side conversations, or non-verbal language. Be sensitive to how easy it can be for someone who is joining virtually to feel isolated. Explain any activity that off-site participants can hear but can't see. Don't let the discussion drag on. Enlist the attendees to help keep the meeting on track. It gets them to take ownership of the meeting.

At appropriate points, ask: Do we have enough information to move forward? Are we in the weeds? Can we take that offline, especially if it doesn't involve the whole team. Recap at the end of the meeting.

Reiterate the next steps, those responsible, and when items are due.

Steve Shuman: Within a day or two of the meeting, send out brief meeting notes and ask for corrections.

Post any slides or visuals online and send everyone the link or a copy. Follow up on the items people are responsible for. Announce the date of the next meeting.

Nancy Topping-Tailby: Because health encompasses so many areas, the National Center on Health has created a variety of topical folders on the Early Childhood Learning and Knowledge Center to help guide the user to relevant resources.

You can find most of the materials the National Center on Health uses to promote Health Services Advisory Committees and community collaboration in the Health Services Management folder. The newly updated version of Weaving Connections preserves the framework of the original 2002 edition and all of the video materials while updating the text to align with the 2007 Head Start Act.

As noted earlier, it contains a new module on how to use technology to promote Health Services
Advisory Committee participation. The other modules cover action planning, membership, recruitment, engaging and orienting, making the HSAC work, evaluating effectiveness, and planning next steps. A twenty-first century vision for your Health Services Advisory Committee is the June 2014 issue of the health services newsletter. Both Weaving Connections and the newsletter are available on the Early Childhood Learning and Knowledge Center.

There are other materials that will help you explore ways to work more effectively with pediatric
practice staff. The fact sheet, the medical home, and Head Start working together may be a helpful resource for practices that are unfamiliar with Head Start. It is also on the Early Childhood Learning and Knowledge Center. In addition, you can share the article by Dr. Marilyn Bull that encourages pediatricians to consider working with Head Start and Early Head Start programs to meet the needs of their most vulnerable patients. The Head Start National Center on Health info line is available to answer your questions by email or phone. This concludes our health chat. Thank you for listening.

 

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(En inglés)

Weaving Connections

[Music]

Man: It kind of makes you feel as if you can cut through a lot of the bureaucracy. And whether you just want to walk in and you have something on your mind, you feel a lot more open that you can go and you can speak to anyone about anything.

Woman: The networking among the membership of the Health Service Advisory Committee is wonderful.

Woman: And you have a canvas, you know? And you can paint what you want on it, and that can be your Health Advisory Committee. [Music]

Narrator: Head Start and Early Head Start programs offer high-quality early childhood education, health and social services, along with a strong parent involvement focus to low income children nationwide. Head Start sees every community as a fabric made up of tightly woven threads. These threads -- the children, families, and community members -- weave intimate connections to create a colorful tapestry that reflects its strengths and warmth. The Health Services Advisory Committee, as required by the Head Start Program Performance Standards, brings together staff, parents, and community members to address emerging health issues, develop plans, policies, and procedures, as well as mobilize community resources. The following stories showed different actions that advisory committees can take to help children build relationships, advocate for change, empower parents, and strengthen communities. Dr. Mimi

Kanda: A good Health Services Advisory Committee makes a big difference in terms of the outcomes for the children, for the families, and for the program itself. You know, normally, in a way, the sky is the limit. And each program has the latitude to really shape its Health Services Advisory Committee in the best way possible. [Music]

Narrator: By assisting a Head Start or Early Head Start program, and responding to the health needs of a particular child, the Health Services Advisory Committee helps improve health services for all children in the program. For Christopher and his mother Penny, this support was critical to their lives from the moment of his birth.

Penny Purser: Well, Christopher came to the Head Start at six weeks old. And his challenges were from birth. He was born with spina bifida. He has one club foot. He had a shunt put in to relieve some of the hydrocephalus around the brain. So he's had a great deal of challenges to overcome. And Head Start's been real supportive with everything.

Narrator: Planning and effective communication allow the Health Services Advisory Committee to support staff in responding to children's needs.

Kari Decoteau: I think just about every person on this reservation knows of his disability and is there to help.

Jaclyn Haight: Everyone understands the story and what his needs are. And you work together and troubleshoot along the way.

Penny: The advisory committee is there to help, and step in, and give whatever help and support that they can. So that's just part of our working together.

Danette Ives: Everybody's pretty much involved with everybody. Now, I think that's how the whole coordination comes along.

Jaclyn: A good example of how the Health Service Committee can help a Head Start or Early Head Start program is -- for us, it was the purchase of some special equipment that we needed for Christopher. We had to say, Okay, these are the costs of-- it was a Ready Racer and a stander.

Penny: With the Head Start funds and the contract health service, they were able to pull their funding together and get him a set so he had the same equipment here that he had at home.

Narrator: The Health Services Advisory Committee in Christopher's community is one part of a team of people who are working to make sure that Christopher, and other children with special health care needs, can have a meaningful Head Start experience.

Ellen Price: It's given him a chance to be mobile and to experience things that he may not have otherwise been able to do. And it's given him a sense of independence.

Danette: The team of people that work for Christopher, everybody cares so much about him. He's just so much a part of this school.

Penny: There's a lot of people out there that really do take care of him, and it takes a lot of people to raise that little boy. [Music]

Narrator: Health emergencies call for immediate action. Health Services Advisory committees help to ensure that systems are in place to mobilize community resources. This Head Start program and its committee members work together to develop policies and procedures for health emergencies.

Woman: Families have to be there --

Sandra Carton: Parents suffer a lot of isolation. They frequently don't speak English. And we do use the advisory committee as the way to link those parents with the community, and to know that there are members in that community that are interested in their well-being.

Janet Schultz: Maria and her husband are parents of a four-year-old little girl and 23-month-old twin girls. And she is now expecting her fourth child. When Early Head Start staff learned that Maria was at risk of losing her baby, they contacted the partners in the community that the Health Services Advisory Committee had helped them establish.

Maria Hercules: When I started having complications with my pregnancy, she's calling, asking to [Inaudible] see me.

Janet: She was monitored for a few days and was prescribed a medication to prevent premature contractions early in pregnancy.

Woman: Very good. 100 over --

Maria: When I start to buy the medicines, it's a little hard. Because I have to take it every four hours. It's expensive medicine.

Narrator: Following the policies and procedures developed by the Health Services Advisory Committee, Early Head Start staff started a plan of action that called on the resources of the committee. The medication was delivered directly to Maria at no charge.

Maria: These people, they gave me the medicine for keeping my baby.

Janet: As a result, we have this wonderful, beautiful healthy little boy.

Maria: It was a little hard, but now I'm so happy. They always, always, when I need it, they'll be here with me. That's truly great. Dr.

Kanda: Like many, many other things in Head Start, you know, it's relationship building. It's partnership development. It's patience, and it's the willingness to really work with people and the willingness to listen to people and to be creative.

Narrator: The solution to some health policy issues may mean going beyond the local level. This Head Start program used its committee to work with other local programs to form a state Health Services Advisory Committee.

Woman: Some things cannot just be solved within your community. It has to be dealt with by the state agencies.

Woman: I'd like to welcome you to the Health Advisory Committee.

Woman: Sometimes, the people on the local level don't have the power. They don't have enough power where, when we take it to the state, we get more answers.

Anne Taggart: We have, at our local community level, we have a Health Service Advisory Committee. Then we also have representatives who go to our state Health Advisory Committee.

Man: For every dollar that came in from Medicaid, the dentist was losing about 25 percent.

Woman: The Medicaid reimbursement rate for dentists was extremely low. And our families were trying to get-- access dental services. They were looking in the larger community for dentists who accept Medicaid. There was not that many dentists that were taking Medicaid.

Narrator: The local Health Services Advisory Committee took this issue to the statewide committee for action at the state level. Head Start staff, parents, health care providers and others worked together to convince the state to increase the Medicaid rates. This allowed families to have greater access to oral health care. Dr. Valsala

Pal: Since the Medicare reimbursement was higher, I was able to get specialists to help me out with handling these children.

Narrator: Parents like Richard care deeply about the quality of oral health services their children receive. Parents participate on the committee to make sure their voices are heard.

Richard Black: It makes you feel really good to know that they have people here who are in the forefront and almost pioneers on issues like this. It just lets you know that, I mean, even at the grassroots level, if you start small, this can be something that can have a big effect nationwide. How do your teeth feel? Do they feel nice and clean? [Music]

Narrator: This Health Services Advisory Committee empowers parents by teaching them about the health care system and how to make it work for their children.

Woman: And still disseminate --

Mary Varela: The Health Service Advisory Committee is doing something that's really unique. And that's that they're taking a problem that seems like it belongs to a certain group, and they're exposing it. You know? They're shining light on it.

Tracey Yee: Our Health Advisory Committee helped us write a grant. And a few of those members sort of became a peer health committee. And we wrote a grant all around, helping parents teaching other parents how to navigate the health care system. -- more comfortable when they go to their doctor if --

Shannon Blas: We train Head Start parents. They learn to navigate through the managed care system and how to partner with their doctor. Then they go back to their site, and they do what's called a "teach back."

Tracey: When we tell them they're going to get up in front of a group of other parents, a lot of them say, I can't see myself doing that. But then, weeks later, they are doing it. And the response they get from their parents that they're teaching I think is so wonderful that they really do become energized.

Marty: In the description, it says, how big is the gash?

Narrator: Parents like Marty actively participate on the committee and help teach other Head Start families to understand the health care system. With three small children of her own, Marty knows how difficult it can be to manage the health care of children.

Marty: This program has given me some information. It's just like, you know, you've got a secret, and you want to tell as many people as possible. They're much more willing to listen to you, because they perceive that you're one of them, and I am. I'm, you know, first and foremost a Head Start parent.

Tracey: To hear parents say that they're advocating for themselves in their doctors' offices, and that they're carrying histories of their child's health with them from provider to provider, or when they move, for us to hear that, I think, is the biggest success.

Woman: Her fever was 99 --

Dr. Stuart Shorr: There's a lot of personal satisfaction. I find that I'm able to use my pediatric expertise to help make certain policies and give certain guidelines which are beneficial to preschoolers.

Marty: I think the most important component of Head Start is that they're not trying to do it all by themselves. They're collaborating with community members.

[Music]

Dr. Kanda: Because Head Start has such a strong emphasis on prevention, that the Health Services Advisory Committee's mission is not just to address problems as they arise, but to be very proactive and to think of prevention and early intervention and how wonderful things can be need to happen in the community.

Bontivia Ben: Okay, ready? I have three kids. One is one year old, three and seven.

Narrator: Bontivia's children were suffering from a health problem that had broader implications for the entire community.

Bontivia: They were tested at the regular health assessment, and I was called a couple of days later. And they told me that their lead level was high, and that they needed to be retested, and my house needed to be checked.

Narrator: Bontivia, a member of the Health Services Advisory Committee, informed the committee about this community problem.

Bontivia: I had a problem with them coming out. I called. I talked to the director of Lead. And he informed me that they had a backlog. But as far as being a parent and other parents, there should have been some kind of communication of telling -- letting you know that there's a backlog or what's going on. Nobody told me anything.

Dr. Habib Shariat: We have like, about 20, 25 members coming from different areas of the community, bringing their expertise, listening to the needs of the community members.

Bontivia: As advocates in this community, that that's totally unacceptable. Right? That we will not accept that they have a backlog.

Woman: Most of the homes are over 60 and 100 years old. So the chances are that any place you've lived, there is lead based paint.

Bontivia: Lead is a priority. They just boosted me more to call. Because I wouldn't have called on my own. Or I probably would have just waited till somebody might have called me back.

Theresa Shivers: The parent becomes her own advocate. I don't have to be there to hold her hand, but I do have to be there to be a role model, to give her an example to go by.

Bontivia: The people encouraged me to keep calling, so I did. And I got a great response back. Right now, I'm happy to say that everything is in process. Last week, someone from the Lead Department came and did an evaluation of a whole house, to do the estimate, so everything could be fixed that needs to be fixed. And I'm happy to say, too, that the lead level has gone down tremendously [Inaudible]

Woman: Great.

Narrator: By bringing the resources of the committee to focus on the issue, the whole community will now benefit from Bontivia's actions.

Theresa: What about all of those other parents out here who don't have anyone else to march down, or walk with them down this road?

Dr. Shariat: I would like to see this group maybe put that on the burner as an issue to be addressed. Participating in more meetings, it gave me the strength and the courage to speak up.

Dr. Janet Unonu: She goes to meetings now and speaks to other parents. And that's what we really want to see. Because she is the one that is going to make that change in her community.

Bontivia: It turns out that they really are happy that I am there. And that they can find out more things that goes on in parents' lives and their kids' lives. So they could find a better way of helping people.

Dr. Kanda: The more you can engage people in the community, and one group brings another in. And before you know it, you have a whole tapestry of people involved. This is something that's bigger than any one of us. And that really has such an impact for the future.

Narrator: The Health Services Advisory Committee, helping children, building relationships, advocating for change, empowering parents, and strengthening communities. Weaving connections that create a healthy future for children and families.

Woman: Doors begin to open up in your own mind, about my goodness, I didn't realize how much power we had. My goodness, I didn't realize how many lives get changed. My goodness, I didn't realize how many health issues come out.

Woman: It's dynamic. It's responsive. It involves parents.

Woman: I think the role of parents becomes really important, because they are the voice of their reality.

Richard: It makes you feel really good to know that your kid is going to get the quality care. 

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