Making It On Our Own - Customizing an Individualized Health Plan [A Learning Activity]

Tailoring the process and forms for Individual Health Plans (IHPs) is an important task for all Head Start programs. This learning activity will help health managers, disability coordinators, and their staff develop their skills in accomplishing this task effectively. It is designed to be completed over time. Required handouts are included.

The following is an excerpt from Caring for Children with Chronic Conditions.

Purpose
For This Activity You Will Need
Steps
Points to Consider
Handout: Sample Individualized Health Plan
Handout: Individualized Planning for Health

Purpose:

This activity helps Head Start staff customize an Individualized Health Plan form to meet the needs of their program.

For this activity you will need:

Steps:

Step 1:

Review the material ... "Individualized Planning For Health."

Step 2:

Think about some children in your program that have special health care needs. Ask:

  • What are the "what if" questions that most worry your teachers and your parents?
  • Which children in your program might benefit from an Individualized Health Plan?

Step 3:

Discuss the issue further with parents of children with special health needs, teachers, managers, and members of your Health Services Advisory Committee. Try to determine:

  • What is the criteria for determining which children with special health care needs get an Individualized Health Plan?
  • What information do you want included on your program's Individualized Health Plan form?

Step 4:

Review your program's health history forms:

  • What information has been helpful?
  • What additional information is needed?

Step 5:

Using your own health history forms, Handout Q: Sample Individualized Health Plan, and other programs' health forms that you may have collected, draft an Individualized Health Plan form that meets your program's needs.

Step 6:

Choose one classroom in your program to test out the process. Using the criteria that you developed in Step 3, identify which children in the class should have an Individualized Health Plan.

  • What proportion of the children in the class need an Individualized Health Plan?
  • If every classroom in your program had the same proportion of children needing an Individualized Health Plan, could the program manage it?
  • Might you need to revise your criteria for which children should have Individualized Health Plans?

Step 7:

Choose one child you identified in Step 6. With the consent and participation of his parent, try to complete the form you drafted in Step 5. If you find that some parts of the form are too difficult to complete, revise the form as needed.

Step 8:

Repeat Step 7 for another child and family, if possible.

Step 9:

Present your draft criteria and draft form for the Individualized Health Plan to your Health Services Advisory Committee. Have the management team and the HSAC work together to determine whether and how to implement individualized health planning in the program.

Points to Consider:

  • The process and forms for Individualized Health Plans are most effective when they are tailored to the needs of the program.
  • After drafting plans and forms, it is important to test how well they work. Often the strengths and weaknesses become apparent only upon implementation. Review and revise the process and forms yearly, if needed.

Handout: Sample Individualized Health Plan

ROUTINE CARE

Today’s Date : ____________________________________________
Review no later than:
___________

Child : __________________________________________________
Birthdate: _____________________

Parent(s) or Guardian(s) : __________________________________
Phone #: ______________________

Primary Health Care Provider : _____________________________
Phone #: ______________________

DIAGNOSIS: 1. ______________________ 2. ______________________
3. _____________________

REGULARLY-SCHEDULED MEDICATIONS

Medication Schedule
(When)
Dose
(How Much)
Route
(How)
Possible Side Effects
         
         
         
Describe accommodations the child needs in daily activities:

Check whether accommodations needed at:

Diet or Feeding: HOME SCHOOL

Classroom Activities:

   

Naptime/Sleeping:

   
Toileting    

Outdoor Activities/Field Trips:

   

Transportation:

   

Other:

   



EMERGENCY CARE

Child : __________________________________________________
Birthdate: _____________________

Parent(s) or Guardian(s) : __________________________________
Phone #: ______________________

Primary Health Care Provider : _____________________________
Phone #: ______________________

DIAGNOSIS:
1. ______________________
2. ______________________
3. ______________________

CALL PARENTS FOR:

 

While waiting for parent(s)or medical help to arrive:

 

GIVE AS NEEDED OR EMERGENCY MEDICATION FOR

Medication Schedule
(When)
Dose
(How Much)
Route
(How)
Possible Side Effects
         
         
         

GET MEDICAL ATTENTION FOR:


CALL 911 (Emergency Medical Services) FOR:

I have helped develop this health plan. I understand it and will try my best to follow the plan. I will communicate any changes in the child’s condition or treatment.

Plan completed: _________(date). Plan will be updated on or before: _________(date).

Parent(s) or Guardian(s): __________________________________________________________________

Head Start Staff Name(s) & Title(s): _________________________________________________________

Health Care Provider Name(s) & Title(s): _____________________________________________________

Other: ________________________________________________________________________________


Handout: Individualized Planning for Health

Background Information

What does it take to care for children with chronic conditions in Head Start? There's no single recipe for all situations. What it takes–more than any policy, list of services, or staffing plan–is a commitment to communication, collaboration and creative problem-solving, and a determination to make it work. The essential principles that should guide the care of children with chronic conditions in Head Start are: care should be family-centered, individualized, safe and legal.

A. Family-Centered Care

Over the last 15 years, children's health care and the relationship between families and health professionals have changed significantly. The role of parents has shifted from being patients to partners with the health care provider; and the "good patient" has changed from unquestioningly following advice to being a good partner, who actively participates in decisions and advocates for services for their child.

"Family-centered care" involves providing the family health care and other services based on the family's needs, priorities, and convenience rather than those of the service providers or the child alone. Family-centered services are consistent with Head Start's approach to family partnerships and supporting child and family development.

Services are family-centered when*...

  • Provide family-centered care:
  • the family is recognized as the child's most constant and important caregiver.
  • the family and professionals collaborate as partners.
  • communication is open and honest, in both directions, between the family and professionals.
  • individual strengths and differences are respected among families.
  • services are flexible and responsive to the family's needs.
  • family-to-family support is encouraged.
  • children with chronic conditions and their families are treated like other children and families, and not defined by their condition.

* Adapted from Shelton, Terri, and Jennifer Smith Stepanek. Family Centered Care for Children Needing Specialized Health and Developmental Services. Association for the Care of Children's Health. Bethesda, Maryland, 1994.

B. Individualized Planning for Health

Head Start aims to individualize services for all children and families from comprehensive screening to individual planning and ongoing assessment. Individualizing means..."recognizing the characteristics that make each child unique and planning a program that responds to these differences. Individualizing allows families and staff to respond to each child's built-in time clock for development, as well as culture, family, home language, life experiences, strengths, needs, skills, and abilities.**"

Head Start can best meet the needs of children with chronic conditions by following a systematic process of Individualized Health Planning. For children who are eligible for an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP), the IEP or IFSP may or may not include planning for the child's health care needs. In addition, many children with special health needs who are not eligible for an IEP or IFSP would, in fact, benefit from individualized health planning. They might be eligible for case management services under Section 504 of the Rehabilitation Act, "Crippled Children's Services," EPSDT, or other programs.

Individualized health planning for children with chronic conditions involves close communication and collaboration among parents, Head Start staff, and service providers. It is a process of collecting all the necessary information from screening and evaluations, developing plans for the child's routine and emergency care, conducting ongoing assessment, and revising the plans as needed. The plan should be documented in writing to serve as a clear guide for Head Start staff, parents, and health care providers on meeting the child's health needs.

The Individualized Health Plan is not specifically required by the Head Start Program Performance Standards. However, the process of developing Individualized Health Plans is an effective tool to facilitate Head Start's goal of individualizing the care of all children, including those with chronic conditions.

  • Who should have an Individualized Health Plan?

    Children who would benefit from an Individualized Health Plan include any child who:

    – requires adaptations in daily activities because of a medical condition; daily activities to be considered include feeding, playing, sleeping, toileting

    – needs medication regularly
    – requires a specialized emergency plan

    The decision to develop an Individualized Health Plan for a child should be made collaboratively by the parent, health specialists, and classroom teacher.

  • What are the benefits of an Individualized Health Plan?

    – Health Promotion and Prevention of Complications:

    Children with chronic conditions remain healthiest when all possible measures are taken to promote their general health and manage the chronic condition closely. These steps are very effective in preventing complications of chronic conditions. For example, for a child with diabetes, it is better to closely monitor her diet and blood sugar levels than to cope with a medical emergency resulting from too low or too high blood sugar levels.

    – Communication and Collaboration:

    Optimal health care for children with chronic conditions requires close communication and coordination among families, Head Start, and health care providers. A systematic process of developing and following the Individualized Health Plan helps clarify the roles and responsibilities of all caregivers and facilitates collaboration.

    – Training and Skills:

    An Individualized Health Plan identifies the specific procedures needed to care for a child with chronic conditions. Head Start management can use the Individualized Health Plan to identify what specific training and supervision must be available for caregivers.

    – Confidence:

    With an Individualized Health Plan, families and Head Start staff can feel confident that they are doing everything possible to keep the child healthy on a routine and daily basis. Also, if health problems or emergencies occur, they can feel confident that they are prepared to manage them in the best way possible. Children with special medical needs feel more secure and able to learn when their caregivers know what to do.

    – Protection from Liability:

    Individualized health planning, staff training, and supervision can improve the care of children with chronic conditions and reduce the chance of medical complications. In the event of complications, the Individualized Health Plan may help provide legal protection for program staff by specifying procedures and clarifying responsibilities.

  • What should be included in an Individualized Health Plan?

    Caring for children with chronic conditions is a serious responsibility. Staff are commonly concerned about meeting the child's daily care needs: "How can I be sure to give him his medicine at the right time? Do we have enough staff to do his tracheostomy care while also supervising the other children? Will I have all his asthma supplies on the field trip?" Staff are also commonly concerned about emergencies: "What if I give her the wrong amount of medicine? What if she stops breathing? What if I can't reach her father on the phone?" The Individualized Health Plan should include the information necessary to respond to the most likely "what-ifs."

    Many people are afraid to care for children with chronic conditions. It can raise anxieties to discuss and plan for the "what-if" situations. It is important to remember, that anticipating and planning for a situation doesn't make it happen; it just allows you to be prepared if it does.

    At minimum, an Individualized Health Plan should be a guide to:

    – what accommodations in daily programming are needed, including meals and snacks, playing, sleeping, and toileting

    – when and how to give medication, and who may give it

    – when and how to perform any required medical procedures, and who may perform them

    – what procedures to follow in the event of a medical emergency

    The Individualized Health Plan should be developed with the participation of families, medical professionals, classroom staff, and relevant members of the Head Start management team (e.g., health, disabilities, nutrition, and education specialists). All parties should sign the form as an indication of agreement with and commitment to plan.

"Making It On Our Own - Customizing an Individualized Health Plan [A Learning Activity]." Caring for Children with Chronic Conditions. Training Guides for the Head Start Learning Community. HHS/ACF/ACYF/HSB. 1998. English.

Last Reviewed: May 2009

Last Updated: August 27, 2015