Health Manager Orientation Guide

Head Start Health Services Year-at-a-Glance

Timeline Based on Child's Enrollment DateServices to All Enrolled Children
At enrollment
  • Health-related paperwork according to the program's policies and procedures, including:
    • Comprehensive health history to plan for safe and inclusive enrollment
    • Consent for health services provided by program (e.g., sensory screenings, growth assessment) and results/documentation of services conducted by external health providers/programs (e.g., physical exam, screenings) [45 CFR §1302.41(b)(1)]
  • Immunizations and timelines according to state, tribal, or territorial regulations [45 CFR §1302.15(e)]
  • External referrals for additional information needed for any special health care need, medication, food accommodation and/or other accommodation to plan for safe, inclusive, and individualized care [45 CFR §1302.60]
  • Internal referrals to service area specialists to plan for safe, inclusive, and individualized care [45 CFR §1302.60]
  • Information to families on the program's health services and policies, including health emergencies that require rapid response [45 CFR §1302.41(b)(2)]
Within 30 days
Within 45 days
Within 90 days
If a program operates for 90 days or fewer, it has 30 days from the date the child first attends the program (45 CFR §1302.42(b)(3)).
  • Determination of child health status [45 CFR §1302.42(b)(1)(i)]
    • Physical and dental exam
    • Screening tests according to the applicable Early and Periodic Screening, Diagnostic and Treatment (EPSDT) schedule

State, tribal, or territorial regulations may require earlier timelines for one or more of these requirements]

  • Follow-up plan for outstanding health services [45 CFR §1302.42(b)(1)(ii)]
  • Individualized health care plan where needed for health and nutrition concerns
  • Follow-up to bring the child up to date with EPSDT recommended screenings, and if needed provide services [45 CFR §1302.42(b)(1)(ii)]
  • Subsequent exams and screenings according to EPSDT schedule or sooner if recommended by medical or dental provider [45 CFR §1302.42(c)(1)]
  • Subsequent immunizations according to the state or territory's schedule [45 CFR §1302.42(c)(1)]
  • Replacement of classroom medications as they expire
  • Periodic observations or other appropriate strategies for program staff and parents to identify any new or recurring developmental, medical, oral, or mental health concerns [45 CFR §1302.42(c)(2)]
  • Ongoing support to assist parents' navigation through health systems to meet the general health and specifically identified needs of their children [45 CFR §1302.46(b)(2)]
Extended Follow-up
  • Follow-up of new or suspected developmental, medical, oral, or mental health concerns identified by parents, staff, and/or health care providers [45 CFR §1302.42(d)(1)]
  • Assistance to parents, as needed, in obtaining any prescribed medications, aids, or equipment for medical and oral health conditions [45 CFR §1302.42(d)(3)]
  • Strategies and practices to support successful transitions for children and their families transitioning out of Early Head Start as it relates to health services [45 CFR §1302.70]
  • Transition strategies to support a successful transition to kindergarten as it relates to health services [45 CFR §1302.70]


Timeline Based on Enrollment Date or as IndicatedServices to Pregnant People and Expectant Families
Within 30 Days
  • Determination of health insurance and medical/dental home within 30 days and provide referrals if needed [45 CFR §1302.80]
Within 2 Weeks After Delivery
  • Prenatal and postpartum educational information provided to parent [45 CFR §1302.81]


Tasks, Timed According to the Program's Planning Cycle and Annual CalendarHealth Services Activities
Trainings to Families and Staff
  • Vehicle and pedestrian safety training for all children and families [45 CFR §1302.46(b)(1)(v)]
  • For programs that provide transportation services:
    • Instruction to children in safe riding practices, safety procedures for boarding and leaving the vehicle and for crossing the street to and from the vehicle at stops, recognition of the danger zones around the vehicle, and emergency evacuation procedures
    • Emergency evacuation drill conducted on the vehicle the child will be riding [45 CFR §1303.74(a)]
    • At least two additional bus evacuation drills conducted during the program year [45 CFR §1303.74(b)]
  • Health-related trainings and educational opportunities for families [45 CFR §1302.46(a)]
  • Health-related trainings for staff [45 CFR §1302.92]:
  • According to program's training calendar
  • As needed in response to results of ongoing monitoring
  • At new staff orientation and on-boarding
Ongoing Monitoring and Continuous Quality Improvement [45 CFR §1302.102(b)(1)]
  • Implementation of health services policies and procedures
  • Health-related recordkeeping
  • Safety practices
  • Health Services Advisory Committee (HSAC) meetings: frequency depends on program goals and objectives, policies and procedures, and need [45 CFR §1302.40(b)]
  • Policy Council meetings
Reporting [45 CFR §1302.102(d)]
  • Ongoing reporting of health data and results of health monitoring
  • External reports according to state, tribal, territory, and other regulatory agencies
  • Program Information Report (PIR)

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